Individual provider Active NPI

Asmahan Ibraheem Mikha

  • General Practice Dentistry
  • El Cajon, CA
National Provider Identifier
1992464655
Registry record updated Dec 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
107175 Issued in CA
Practice address
2654 Jamacha Rd Ste 113
El Cajon, CA 92019-4327
Phone
(619) 303-0930
NPI assigned
Dec 9, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 107175 CA Primary

Addresses

Primary practice location

2654 Jamacha Rd Ste 113
El Cajon, CA 92019-4327

Mailing address

1155 Tucson CT
El Cajon, CA 92021-5123
Phone (480) 658-8222

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

LicenseStateTypeSpecialty
107175CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1639008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639008000000",
    "number": "1992464655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1155 TUCSON CT",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920215123",
            "telephone_number": "480-658-8222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2654 JAMACHA RD STE 113",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920194327",
            "telephone_number": "619-303-0930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIKHA",
        "first_name": "ASMAHAN",
        "middle_name": "IBRAHEEM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-09",
        "last_updated": "2021-12-09",
        "certification_date": "2021-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "107175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Cajon, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2021; 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.