Individual provider Active NPI

Mounir Nassif Guirguis, DDS

  • General Practice Dentistry
  • Antioch, CA
National Provider Identifier
1134458177
Registry record updated Dec 22, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
59061 Issued in CA
Practice address
2590 Sycamore Dr
Antioch, CA 94509-2909
Phone
(800) 579-3783
NPI assigned
Dec 22, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 59061 CA Primary

Addresses

Primary practice location

2590 Sycamore Dr
Antioch, CA 94509-2909

Mailing address

12022 Mountain Pass Rd
San Diego, CA 92128-5259
Phone (858) 748-0180

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

Interoperability endpoints

  • Direct secure messaging: mguirguis@direct.westerndental.com

NPI Registry JSON

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

{
    "created_epoch": "1261440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1261440000000",
    "number": "1134458177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12022 MOUNTAIN PASS RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921285259",
            "telephone_number": "858-748-0180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2590 SYCAMORE DR",
            "city": "ANTIOCH",
            "state": "CA",
            "postal_code": "945092909",
            "telephone_number": "800-579-3783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUIRGUIS",
        "first_name": "MOUNIR",
        "middle_name": "NASSIF",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-12-22",
        "last_updated": "2009-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "59061",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Antioch, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2009; 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.