Moheb DMD Inc

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

MOHEB DMD INC

Practice address

1844 San Miguel Dr
Ste 206
Walnut Creek, CA 94596-4962

Phone

(925) 279-3326

Fax

(925) 279-2270

NPI assigned

Dec 13, 2010

Organization subpart

No

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

Authorized official

Name

Ms. Blanca Casillas

Title

Vice President

Phone

(925) 300-3992

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• San Miguel Dental Group Doing business as

Tax ID family

Moheb DMD Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Moheb DMD Inc

  • Dentist
  • Vacaville, CA
  • NPI 1487957494
  NPD tax ID
• Moheb DMD Inc

  • Dentist
  • Oakland, CA
  • NPI 1740583756
  NPD tax ID

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Maryam Ezadi Khakpour

  • General Practice Dentistry
  • Walnut Creek, CA
  • NPI 1811107725
  NPD (past)
• Hala Hamid Mealing, DDS

  • Dentist
  • Walnut Creek, CA
  • NPI 1083695431
  NPD (past)
• Alireza Moheb, DMD

  • Dentist
  • Walnut Creek, CA
  • NPI 1013096502
  NPD (past)

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

{
    "created_epoch": "1292198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576800000000",
    "number": "1841593852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1844 SAN MIGUEL DR STE 206",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945964963",
            "telephone_number": "925-457-6906",
            "fax_number": "925-952-7376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1844 SAN MIGUEL DR",
            "address_2": "STE 206",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945964962",
            "telephone_number": "925-279-3326",
            "fax_number": "925-279-2270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOHEB DMD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-13",
        "last_updated": "2019-12-20",
        "certification_date": "2019-12-20",
        "status": "A",
        "authorized_official_last_name": "CASILLAS",
        "authorized_official_first_name": "BLANCA",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "925-300-3992",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1841593852",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "San Miguel Dental Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "San Miguel Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• William Keith Modenbach, DC
• Harshil Modi
• Jamal Raji Mogannam, MD
• Alexandra L Mogilevets
• Hind Mohamed
• Alireza Moheb, DMD
• Arash Mohebati, MD
• Ann Susan Mohler, MD
• Gaia Mohr-Tonachini, MMSC
• Vanitha Mohta, MD

• Dentist in Walnut Creek, CA
• Providers in Walnut Creek, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.