| Momani Dds Inc | |
|
3025 Mchenry Ave Ste N Modesto CA 95350 | |
| (209) 527-3990 | |
| Not Available |
| Full Name | Momani Dds Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 3025 Mchenry Ave Ste N, Modesto, California |
| Authorized Official Name and Position | Ahmad Momani (CEO) |
| Authorized Official Contact | 2095273990 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Momani Dds Inc 3025 Mchenry Ave Ste N Modesto CA 95350-1449 Ph: (209) 535-9933 | Momani Dds Inc 3025 Mchenry Ave Ste N Modesto CA 95350 Ph: (209) 527-3990 |
| NPI Number | 1215329487 |
|---|---|
| Provider Enumeration Date | 02/25/2015 |
| Last Update Date | 01/15/2020 |
| Medicare PECOS PAC ID | 8325395932 |
|---|---|
| Medicare Enrollment ID | O20180726003162 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215329487 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 59081 (California) | Primary |
| Provider Name | Ahmad Momani |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1538490214 PECOS PAC ID: 9234486846 Enrollment ID: I20180726003183 |
| Provider Name | Noreen Haseeb |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1447674817 PECOS PAC ID: 7618388372 Enrollment ID: I20201201002570 |
| Provider Name | Freddy E Laparra |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1306896022 PECOS PAC ID: 7012328719 Enrollment ID: I20201202000868 |
| Provider Name | Farid A Zurmati |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1588767669 PECOS PAC ID: 9133532203 Enrollment ID: I20210108002393 |
| Provider Name | Leo Choti |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1477166676 PECOS PAC ID: 5597171298 Enrollment ID: I20210303003463 |
| Provider Name | Ronnys Capote Cabrera |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1568058725 PECOS PAC ID: 2961803945 Enrollment ID: I20210628003452 |
| Provider Name | Martin Juan Hernandez |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1861083396 PECOS PAC ID: 7416353529 Enrollment ID: I20210914003143 |
| Provider Name | Pablo Madrigal |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1457029167 PECOS PAC ID: 3678961240 Enrollment ID: I20211101001829 |
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