Maryam Ghazi, RDH
Individual provider Active NPI Dental Hygienist · McCloud, CA
NPI 1114498607 · NPPES record last updated Mar 10, 2026
Key facts
- NPI
- 1114498607
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dental Hygienist 124Q00000X
- License
- 18611 (CA)
- Practice address
- 116 W Minnesota Ave.
McCloud, CA 96057 - Phone
- (530) 964-2040
- NPI assigned
- Dec 10, 2018
- Reactivated
- Mar 10, 2026
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18611 | CA | MD | Dental Hygienist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 18611 | CA | Yes |
Addresses
Primary practice location
116 W Minnesota Ave.
McCloud, CA 96057
Mailing address
3421 Summit Dr
Mount Shasta, CA 96067-9163
Other practice location 1
116 W Minnesota Ave.
McCloud, CA 96057
Phone (530) 964-2040
Other providers in McCloud, CA
- Susan Renae Berliner
- Antone Briseno
- Alan David Cooper
- Christine Crouch
- William Clark Foy
- Thomas M Klassy
- Denise Lewis
- McCloud Community Services District
- McCloud Healthcare Clinic, Inc.
- McCloud Union Elementary School
All providers in McCloud, CA · Dental Hygienist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 10, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.