Su Mei Mai, | |
3745 Fredricksburg St Apt B, Fort Irwin, CA 92310-1701 | |
(270) 798-8751 | |
Not Available |
Full Name | Su Mei Mai |
---|---|
Gender | Female |
Speciality | Dentist |
Location | 3745 Fredricksburg St Apt B, Fort Irwin, California |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1487179743 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | 101839 (California) | Primary |
Entity Name | Kwon Dds Professional Corporation |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1881021434 PECOS PAC ID: 5698159283 Enrollment ID: O20220831001246 |
Mailing Address | Practice Location Address |
---|---|
Su Mei Mai, 3745 Fredricksburg St Apt B, Fort Irwin, CA 92310-1701 Ph: (270) 798-8751 | Su Mei Mai, 3745 Fredricksburg St Apt B, Fort Irwin, CA 92310-1701 Ph: (270) 798-8751 |
Dr. Stephanie Chung Lee, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 171 Inner Loop Road, Fort Irwin, CA 92310 Phone: 760-380-3166 | |
Ryan Steven Payne, Dentist Medicare: Not Enrolled in Medicare Practice Location: 4th & Inner Loop Road, Bldg 171, Fort Irwin, CA 92310 Phone: 719-526-5537 Fax: 706-787-2082 | |
Dr. Brent Wayne Clark, DMD Dentist Medicare: Not Enrolled in Medicare Practice Location: 390 North Loop Rd., Fort Irwin, CA 92310 Phone: 760-383-5289 | |
Dr. Joshua Hyungkyu Lee, D.D.S. Dentist Medicare: Not Enrolled in Medicare Practice Location: 4th And Inner Loop Road, Bldg 171, Fort Irwin, CA 92310 Phone: 719-526-5537 | |
Dr. Yong Soo Kim, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 171 Inner Loop Rd, Fort Irwin, CA 92310 Phone: 760-380-3166 | |
Dustin Tyler Nygard, DMD Dentist Medicare: Not Enrolled in Medicare Practice Location: Bldg, 390 N Loop Rd, Fort Irwin, CA 92310 Phone: 760-380-3166 | |
Dr. Sergio Hernandez, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 171 Inner Loop Rd, Fort Irwin, CA 92310 Phone: 760-380-3173 |