Individual provider Active NPI

Mori Naftulin, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Truckee, CA
National Provider Identifier
1740714005
Registry record updated Jul 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
DDS103163 Issued in CA
Practice address
40165 Truckee Airport Rd Ste 303
Truckee, CA 96161-4108
Phone
(530) 587-5440
Fax
(530) 541-4443
NPI assigned
Apr 13, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X DDS103163 CA Primary

Addresses

Primary practice location

40165 Truckee Airport Rd Ste 303
Truckee, CA 96161-4108

Mailing address

40165 Truckee Airport Rd Ste 303
Truckee, CA 96161-4108
Phone (530) 587-5440

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 7, 2026 through Jan 7, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DDS103163CAMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Lima Memorial Joint Operating Company Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1492041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752105600000",
    "number": "1740714005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40165 TRUCKEE AIRPORT RD STE 303",
            "city": "TRUCKEE",
            "state": "CA",
            "postal_code": "961614108",
            "telephone_number": "530-587-5440",
            "fax_number": "530-541-4443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40165 TRUCKEE AIRPORT RD STE 303",
            "city": "TRUCKEE",
            "state": "CA",
            "postal_code": "961614108",
            "telephone_number": "530-587-5440",
            "fax_number": "530-541-4443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAFTULIN",
        "first_name": "MORI",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-13",
        "last_updated": "2025-07-10",
        "certification_date": "2025-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "DDS103163",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Truckee, CA

Sources for this page

Verify at the official NPI Registry.