Mona Mahmoodi DDS Inc

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

62200 Issued in CA

Legal business name

MONA MAHMOODI DDS INC

Doing business as

Park Plaza Dental

Practice address

245 Kentucky St Ste E
Petaluma, CA 94952-2877

Phone

(707) 763-4142

NPI assigned

Sep 28, 2014

Last updated

Sep 28, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Mona MahmoodiNPI 1295076768

Title

DDS/Dentist

Phone

(310) 993-5758

Specialties & licenses 1

Addresses

Other names 1

• Park Plaza Dental Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mona Mahmoodi

  • Dentist
  • San Francisco, CA
  • NPI 1295076768
  Authorized official Same address or phone

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

{
    "created_epoch": "1411862400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411862400000",
    "number": "1154724763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 KENTUCKY ST STE E",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949522877",
            "telephone_number": "707-763-4142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 KENTUCKY ST STE E",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949522877",
            "telephone_number": "707-763-4142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONA MAHMOODI DDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-28",
        "last_updated": "2014-09-28",
        "status": "A",
        "authorized_official_last_name": "MAHMOODI",
        "authorized_official_first_name": "MONA",
        "authorized_official_title_or_position": "DDS/DENTIST",
        "authorized_official_telephone_number": "310-993-5758",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "62200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Park Plaza Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jamie Nikol Molina
• Lourdes Mercedes Molina
• Antenor Tercero Molloy
• Nida Faiz Momand
• Momentum Behavior Services, LLC
• Celeste Desiree Montalvo, FNP
• Jennifer Ortiz Monteclaro, MD
• Laney Montes de Oca-Navarrete
• Samantha Liseth Montes Garcia
• Jose Franco Montes

• General Practice Dentistry in Petaluma, CA
• Providers in Petaluma, 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 Sep 28, 2014; 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.