Mona Momeni Moghaddam

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

112043 Issued in CA

Practice address

616 W Hammer LN Ste B
Stockton, CA 95210-3749

Phone

(209) 634-4092

NPI assigned

May 29, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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

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.

• Western Dental Services, Inc.

  • Dentist
  • Stockton, CA
  • NPI 1801363825
  NPD (past)

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

{
    "created_epoch": "1685318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764892800000",
    "number": "1457044323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4229 BELCARRA CT",
            "city": "DUBLIN",
            "state": "CA",
            "postal_code": "945687807",
            "telephone_number": "209-298-6901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "616 W HAMMER LN STE B",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952103749",
            "telephone_number": "209-634-4092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOMENI MOGHADDAM",
        "first_name": "MONA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-29",
        "last_updated": "2025-12-05",
        "certification_date": "2025-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MI",
            "license": "2901602400",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "112043",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rico Diego Molina, MSW
• Sasha Monzerrath Molina
• Tori Lynn Molina
• John Carl Molthen, DC
• Momani DDS Inc
• Jeulliette Momjian
• Kim Pedro Mompean
• Livier Monarrez
• Martinique Moncrieffe, MD
• Zenat Moneeb

• Pediatric Dentistry in Stockton, CA
• Providers in Stockton, CA by specialty
• Pediatric Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2025; 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.