Maha Hetata, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

40830 Issued in CA

Practice address

267 E 17TH St
Costa Mesa, CA 92627-3831

Phone

(949) 646-2411

Fax

(949) 646-9141

NPI assigned

Aug 14, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Hetata & Alkhateeb Dental Corp

  dba Mesa Dental Center

  • Dentist
  • Costa Mesa, CA
  • NPI 1235315433
  NPD (past) Authorized official
• Al Khateeb D.D.S Dental Corporation

  • Oral and Maxillofacial Surgery (Dentist)
  • Costa Mesa, CA
  • NPI 1558812420
  NPD (past)

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

{
    "created_epoch": "1344902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344902400000",
    "number": "1154678647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "267 E 17TH ST",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926273831",
            "telephone_number": "949-646-2411",
            "fax_number": "949-646-9141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "267 E 17TH ST",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926273831",
            "telephone_number": "949-646-2411",
            "fax_number": "949-646-9141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HETATA",
        "first_name": "MAHA",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-14",
        "last_updated": "2012-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "40830",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Frederick Herrmann, DPM
• Megan Hersh, DPT
• Phillip Robert Hersh, D.C.
• Samantha Eunelva Hess
• Hetata & Alkhateeb Dental Corp (Mesa Dental Center)
• Hhcsc Inc (All Valley Home Care OC)
• Novella Hicks, MSW
• Nathan Hidajat
• Isabella Guliania Hidalgo
• Kelly Hidalgo

• General Practice Dentistry in Costa Mesa, CA
• Providers in Costa Mesa, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2012; 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.