MEDICARE: DR. MOUHAMADOU SEYDI DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	204E00000X	Oral & Maxillofacial Surgery (D.M.D.)	41089	TX
2	204E00000X	Oral & Maxillofacial Surgery (D.M.D.)	14099	NC

General Provider Information

NPI Number	:	1689241838
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MOUHAMADOU SEYDI DDS

Provider Business Mailing Address
First Line	:	4015 CRAFT ST APT 5244
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28217-1690
Country	:	US
Telephone Number	:	313-427-5391
Fax Number	:

Provider Business Practice Location Address
First Line	:	527 S NEW HOPE RD
Second Line	:
City	:	GASTONIA
State	:	NC
Zip	:	28054-4040
Country	:	US
Telephone Number	:	980-448-3144
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/07/2021
Last Update Date	:	06/11/2026

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