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31726 Rancho Viejo Rd Suite 109 San Juan Capistrano CA 92675-2779 | |
| (949) 481-1212 | |
| (949) 258-9822 |
| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 31726 Rancho Viejo Rd, San Juan Capistrano, California |
| Authorized Official Name and Position | Mojgan Niktash (DENTIST) |
| Authorized Official Contact | 9494812121 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
31726 Rancho Viejo Rd Ste B-109 San Juan Capistrano CA 92675-2779 Ph: (949) 481-2121 | 31726 Rancho Viejo Rd Suite 109 San Juan Capistrano CA 92675-2779 Ph: (949) 481-1212 |
| NPI Number | 1407267974 |
|---|---|
| Provider Enumeration Date | 05/17/2014 |
| Last Update Date | 01/12/2021 |
| Medicare PECOS PAC ID | 1557776341 |
|---|---|
| Medicare Enrollment ID | O20210208002151 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407267974 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 45598 (California) | Primary |
| Provider Name | Mogjan Niktash |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1023432937 PECOS PAC ID: 1658671110 Enrollment ID: I20210430001576 |
Christine A Fortmann Dds Inc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 32281 Camino Capistrano Ste C102, San Juan Capistrano, CA 92675 Phone: 949-429-8833 | |
Pelican Point Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 31103 Rancho Viejo Road Ste D2444, San Juan Capistrano, CA 92675 Phone: 562-964-0877 | |
Dr. Mark Sayed D.m.d. Inc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 32341 Camino Capistrano Ste H, San Juan Capistrano, CA 92675 Phone: 949-493-3993 Fax: 949-493-9562 | |
Mariam Soldin-wasfi Dmd Professional Corp Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 31105 Rancho Viejo Rd Ste C2, San Juan Capistrano, CA 92675 Phone: 949-218-3607 | |
Homecare Dentists Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 27126 Paseo Espada Ste 705, San Juan Capistrano, CA 92675 Phone: 949-429-7100 Fax: 949-429-7101 |