Individual provider Active NPI

Mohamed Soliman

  • Dentist
  • Elk Grove, CA
National Provider Identifier
1023132354
Registry record updated Jun 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
52002 Issued in CA
Practice address
9015 Bruceville Rd Ste 130
Elk Grove, CA 95758-5958
Phone
(916) 683-5732
NPI assigned
Mar 19, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 52002 CA Primary

Addresses

Primary practice location

9015 Bruceville Rd Ste 130
Elk Grove, CA 95758-5958

Mailing address

5309 Iris Spring Way
Elk Grove, CA 95757-3302
Phone (916) 479-2447

Other practice location 1

9340 W Stockton Blvd
Elk Grove, CA 95758-8014
Phone (916) 683-5732

Other practice location 2

2045 W Briggsmore Ave
Modesto, CA 95350-3767
Phone (209) 527-3000

Other identifiers 1

IdentifierTypeStateIssuer
D52002MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
52002CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Mohamed Soliman DDS PC Current Accepting new patients
Mohamed Soliman Dental Corp Dentist Past Accepting new patients
Western Dental Services, Inc. Past Accepting new patients

Locations

9015 Bruceville Rd
Ste 130
Elk Grove, CA 95758
Phone (915) 683-5732

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686787200000",
    "number": "1023132354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5309 IRIS SPRING WAY",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957573302",
            "telephone_number": "916-479-2447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9015 BRUCEVILLE RD STE 130",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957585958",
            "telephone_number": "916-683-5732"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9340 W Stockton Blvd",
            "address_purpose": "LOCATION",
            "city": "Elk Grove",
            "state": "CA",
            "postal_code": "957588014",
            "country_code": "US",
            "telephone_number": "916-683-5732",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2045 W Briggsmore Ave",
            "address_purpose": "LOCATION",
            "city": "Modesto",
            "state": "CA",
            "postal_code": "953503767",
            "country_code": "US",
            "telephone_number": "209-527-3000",
            "fax_number": "209-548-9469",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SOLIMAN",
        "first_name": "MOHAMED",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-19",
        "last_updated": "2023-06-15",
        "certification_date": "2023-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "52002",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D52002",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elk Grove, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.