| Maryam Waheed Dental Group Corp | |
|
22373 El Toro Rd Lake Forest CA 92630-5053 | |
| (516) 840-0409 | |
| Not Available |
| Full Name | Maryam Waheed Dental Group Corp |
|---|---|
| Speciality | Dentist |
| Location | 22373 El Toro Rd, Lake Forest, California |
| Authorized Official Name and Position | Maryam Waheed (PRESIDENT) |
| Authorized Official Contact | 5168400409 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Maryam Waheed Dental Group Corp 22373 El Toro Rd Lake Forest CA 92630-5053 Ph: (516) 840-0409 | Maryam Waheed Dental Group Corp 22373 El Toro Rd Lake Forest CA 92630-5053 Ph: (516) 840-0409 |
| NPI Number | 1932676699 |
|---|---|
| Provider Enumeration Date | 10/30/2018 |
| Last Update Date | 06/08/2022 |
| Medicare PECOS PAC ID | 9638415193 |
|---|---|
| Medicare Enrollment ID | O20190104001538 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932676699 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
| Provider Name | Maryam Waheed |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1861869976 PECOS PAC ID: 8325384894 Enrollment ID: I20190104001653 |
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