Niki Negar Moghadasi
Individual provider Active NPI General Practice Dentistry · Silverado, CA
NPI 1558051128 · NPPES record last updated Dec 16, 2024
Key facts
- NPI
- 1558051128
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 110768 (CA)
- Practice address
- 18021 Merlin St
Silverado, CA 92676-9657 - Phone
- (310) 968-6891
- NPI assigned
- May 8, 2023
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 110768 | CA | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 110768 | CA | Yes |
Addresses
Primary practice location
18021 Merlin St
Silverado, CA 92676-9657
Mailing address
18021 Merlin St
Silverado, CA 92676-9657
Phone (310) 968-6891
Other providers in Silverado, CA
All providers in Silverado, CA · General Practice Dentistry in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 16, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.