Michael Mohamed Aljabban, D.M.D

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DDS110040 Issued in CA

Practice address

16944 S Highland Ave Ste 400
Fontana, CA 92336-3467

Phone

(909) 746-9960

NPI assigned

Apr 12, 2023

Sex

Male

Sole proprietor

No

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 22, 2024.

{
    "created_epoch": "1681257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721606400000",
    "number": "1346936341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16944 S HIGHLAND AVE STE 400",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923363467",
            "telephone_number": "909-746-9960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16944 S HIGHLAND AVE STE 400",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923363467",
            "telephone_number": "909-746-9960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALJABBAN",
        "first_name": "MICHAEL",
        "middle_name": "MOHAMED",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-04-12",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "DDS110040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Omar Alfaro, DDS
• Anaivis Alfonso Gonzalez, FNP
• Alfred B Dadivas MD Inc
• Aavaisra Ali
• Uzma Rifat Ali, MD
• Lupe A Alle-Corliss, LCSW
• Randall M Alle-Corliss, LCSW
• Kimberly Irene Allen, LVN
• Matthew Allen
• Allied Medical Supply, Inc

• All providers in Fontana, CA
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.