Active NPI
Mohamed Mostafa Seleem, DDS
- General Practice Dentistry
- Victorville, CA
National Provider Identifier
1356479786
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 46132
- Practice address
- 15366 Seventh St Ste G
Victorville, CA 92395-3837 - Phone
- (760) 245-8616
- Fax
- (760) 245-2490
- NPI assigned
- Feb 28, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 46132 | CA | Primary |
Addresses
Primary practice location
15366 Seventh St Ste G
Victorville, CA 92395-3837
Mailing address
11458 Southampton CT
Rancho Cucamonga, CA 91730
Phone (909) 268-4616
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 46132 | CA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172620800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1221696000000",
"number": "1356479786",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11458 SOUTHAMPTON CT",
"city": "RANCHO CUCAMONGA",
"state": "CA",
"postal_code": "91730",
"telephone_number": "909-268-4616",
"fax_number": "909-355-2715"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15366 SEVENTH ST STE G",
"city": "VICTORVILLE",
"state": "CA",
"postal_code": "923953837",
"telephone_number": "760-245-8616",
"fax_number": "760-245-2490"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SELEEM",
"first_name": "MOHAMED",
"middle_name": "MOSTAFA",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-28",
"last_updated": "2008-09-18",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "46132",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Victorville, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.