| Irina Moga Dds Pc | |
|
14475 Sw Allen Blvd Beaverton OR 97005-4418 | |
| (503) 646-5909 | |
| (503) 646-5908 |
| Full Name | Irina Moga Dds Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 14475 Sw Allen Blvd, Beaverton, Oregon |
| Authorized Official Name and Position | Irina Moga (OWNER) |
| Authorized Official Contact | 5036465909 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Irina Moga Dds Pc 14425 Sw Allen Blvd Beaverton OR 97005-4402 Ph: (503) 646-5909 | Irina Moga Dds Pc 14475 Sw Allen Blvd Beaverton OR 97005-4418 Ph: (503) 646-5909 |
| NPI Number | 1750656377 |
|---|---|
| Provider Enumeration Date | 03/14/2012 |
| Last Update Date | 07/07/2021 |
| Medicare PECOS PAC ID | 7517375330 |
|---|---|
| Medicare Enrollment ID | O20210422001119 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750656377 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | D8510 (Oregon) | Primary |
| Provider Name | Irina Moga |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1952329526 PECOS PAC ID: 4688954076 Enrollment ID: I20210928002994 |
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