| Creekside Dental | |
|
41785 Nicole Ln Ste A3 Temecula CA 92591-3874 | |
| (951) 699-3250 | |
| (951) 699-3830 |
| Full Name | Creekside Dental |
|---|---|
| Speciality | Dentist |
| Location | 41785 Nicole Ln Ste A3, Temecula, California |
| Authorized Official Name and Position | Andy Hoang (OWNER) |
| Authorized Official Contact | 9516993250 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Creekside Dental 41785 Nicole Ln Ste A3 Temecula CA 92591-3874 Ph: (951) 699-3250 | Creekside Dental 41785 Nicole Ln Ste A3 Temecula CA 92591-3874 Ph: (951) 699-3250 |
| NPI Number | 1508105255 |
|---|---|
| Provider Enumeration Date | 01/31/2013 |
| Last Update Date | 09/22/2020 |
| Medicare PECOS PAC ID | 8820239361 |
|---|---|
| Medicare Enrollment ID | O20190523002698 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508105255 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
| 332B00000X | Durable Medical Equipment & Medical Supplies | (* (Not Available)) | Secondary |
| Provider Name | Mahyar A Karimi |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1891942652 PECOS PAC ID: 5395968994 Enrollment ID: I20140618001861 |
| Provider Name | Andy T Hoang |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1477669943 PECOS PAC ID: 0648411181 Enrollment ID: I20190529000377 |
| Provider Name | Dexter Nguyen |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1447779327 PECOS PAC ID: 2163839549 Enrollment ID: I20210331002154 |
| Provider Name | Ha Nhat Vo |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1285174904 PECOS PAC ID: 9234546565 Enrollment ID: I20210401001353 |
| Provider Name | Robert N Sharobiem |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1770898702 PECOS PAC ID: 6103100672 Enrollment ID: I20211117001736 |
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