1093961575 NPI number — MOHAMMAD HOSSEIN MOHAMMADI-ARAGHI D.D.S., MS

Table of content: MOHAMMAD HOSSEIN MOHAMMADI-ARAGHI D.D.S., MS (NPI 1093961575)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1093961575 NPI number — MOHAMMAD HOSSEIN MOHAMMADI-ARAGHI D.D.S., MS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MOHAMMADI-ARAGHI
Provider First Name:
MOHAMMAD
Provider Middle Name:
HOSSEIN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
D.D.S., MS
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MOHAMMADI
Provider Other First Name:
MOHAMMAD
Provider Other Middle Name:
HOSSEIN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1093961575
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/15/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
25571 JEROMINO RD
Provider Second Line Business Mailing Address:
SUITE 11
Provider Business Mailing Address City Name:
MISSION VIEJO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92691
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
949-707-5533
Provider Business Mailing Address Fax Number:
909-613-1183

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
25571 JEROMINO RD
Provider Second Line Business Practice Location Address:
SUITE 11
Provider Business Practice Location Address City Name:
MISSION VIEJO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92691
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
949-707-5533
Provider Business Practice Location Address Fax Number:
909-613-1183
Provider Enumeration Date:
08/15/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1223S0112X , with the licence number:  S2200 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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