Individual provider Active NPI

Deep Muko, D.D.S.

  • Dentist
  • Temecula, CA
National Provider Identifier
1104973593
Registry record updated Oct 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
103310 Issued in CA
Practice address
32605 Temecula Pkwy Ste 213
Temecula, CA 92592-6839
Phone
(951) 303-2818
Fax
(951) 303-6213
NPI assigned
Jan 5, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 25, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 103310 CA Primary

Addresses

Primary practice location

32605 Temecula Pkwy Ste 213
Temecula, CA 92592-6839

Mailing address

32605 Temecula Pkwy Ste 213
Temecula, CA 92592-6839
Phone (951) 296-9661

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
103310CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Deep Muko DDS Inc Dentist Current Accepting new patients
Deep Muko DDS, Inc. Dentist Current Accepting new patients
Mukherjee DDS Corp PastSince Oct 1, 2019 Accepting new patients
R. Mukherjee Dental Inc. PastSince Oct 1, 2019 Accepting new patients

Locations

32605 US Highway 79
Ste 213
Temecula, CA 92592
Phone (951) 303-2818

Organizations & group practices 4

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": "1167955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635120000000",
    "number": "1104973593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32605 TEMECULA PKWY STE 213",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925926839",
            "telephone_number": "951-296-9661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32605 TEMECULA PKWY STE 213",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925926839",
            "telephone_number": "951-303-2818",
            "fax_number": "951-303-6213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUKO",
        "first_name": "DEEP",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-05",
        "last_updated": "2021-10-25",
        "certification_date": "2021-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "103310",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Temecula, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2021; 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.