Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 30 days.

DR. SIAMAC MASHOD DDS
NPI 1174522387
Dentist in Jacksonville, FL

Active since July 19, 2005
11190 MONUMENT LANDING BLVD, JACKSONVILLE, FL 32225(904) 645-9162(904) 998-8812 Get Directions Write a Review

NPPES record last updated: July 13, 2026. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Dr. Siamac Mashod Dds NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. SIAMAC MASHOD DDS (NPI 1174522387) is an individual dentist in Jacksonville, Florida, licensed in Florida (11314) and active in the NPI registry since July 2005.

NPPES Registry Identity

NPI1174522387
Entity TypeIndividualMale
Primary Taxonomy122300000X
Provider Legal NameDR. SIAMAC MASHODCredential: DDS
Location Address11190 MONUMENT LANDING BLVDJacksonville, FL 32225-4580
Mailing Address11190 Monument Landing BlvdJacksonville, FL 32225 · (904) 645-9162 · Fax (904) 998-8812
Fax(904) 998-8812
Sole ProprietorNo
Enumeration DateJuly 19, 2005
Last NPPES UpdateJuly 13, 2026
NPI 1174522387 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
License Licensed in FL · 11314
Definition

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

11190 MONUMENT LANDING BLVD, Jacksonville, FL 32225

Accepted Insurance

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1174522387, enumerated as an "individual" on July 19, 2005.

The provider is located at 11190 MONUMENT LANDING BLVD JACKSONVILLE, FL 32225 and the phone number is (904) 645-9162.

Dentist with taxonomy code 122300000X.

The provider might be accepting Accepts: Blue Cross and Blue Shield of Montana, Blue Cross. Please consult your insurance carrier or call the provider to verify.