MONA MAHMOODI DDS INC (NPI# 1154724763) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154724763 |
| Entity Type | Organization |
| Organization Name | MONA MAHMOODI DDS INC |
| Other Organization Name | PARK PLAZA DENTAL |
| Practice Address |
245 Kentucky St Ste E Petaluma CA 94952-2877 |
| Practice Telephone | 7077634142 |
| Mailing Telephone | 7077634142 |
| Enumeration Date | 2014-09-28 |
| Last Update Date | 2014-09-28 |
| Authorized Official Name | DR. MONA MAHMOODI (DDS/DENTIST) |
| Authorized Official Telephone | 3109935758 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
62200 | CA | Dental Providers |
| Other Name | Type Code |
|---|---|
| Park Plaza Dental | Doing Business As Name - Organization |
| Street Address |
245 KENTUCKY ST STE E |
| City | PETALUMA |
| State | CA |
| Zip Code | 94952-2877 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720483225 | Park Plaza Dental | Dentist | 245 Kentucky St Ste E, Petaluma, CA 94952-2877 | 2014-10-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114587680 | Benjamin R Idarius | Behavior Technician | 101 H St. Ste. L, Petaluma, CA 94952 | 2019-06-17 |
| 1518457159 | Kyleen Joan Romero | Behavioral Analyst | 25 Graylawn Ave, Petaluma, CA 94952 | 2018-05-17 |
| 1437647526 | John Scruggs | Behavior Technician | 301 H St. Suit L, Petaluma, CA 94952 | 2018-04-25 |
| 1811404684 | Brief and Strategic Counseling Service | Counselor | 843 Chardonnay Cir., Petaluma, CA 94952 | 2018-01-03 |
| 1730638396 | Jennifer Lee Sloan | Acupuncturist | 517 Hayes Lane, Petaluma, CA 94952 | 2016-09-23 |
| 1982057295 | Elene Hwa-yihg Chung | Acupuncturist | 130 Graylawn Ave.,#f, Petaluma, CA 94952 | 2016-07-21 |
| 1457773624 | Lisa Hirsch Cordeiro | Marriage & Family Therapist | 700 Sixth Street, Petaluma, CA 94952 | 2014-01-07 |
| 1811271075 | Jacques Philippe Archer | Massage Therapist | 131b Kentucky St., Petaluma, CA 94952 | 2011-10-06 |
| 1477841609 | Karna Licia Dawson | Social Worker | 205 Keller St., Petaluma, CA 94952 | 2011-07-21 |
| 1497051783 | Melissa Beth Wilson | Acupuncturist | 155a Kentucky Street, Petaluma, CA 94952 | 2011-02-03 |
| Find all providers in zip 94952 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205262664 | Nosti and Gill Dental Corporatiom | Dentist | 401 Kenilworth Dr Ste 960, Petaluma, CA 94952-3406 | 2013-09-17 |
| 1093156242 | Reza K. Aryanpour Dds, A Dental Corporation | Dentist | 1436 Professional Dr Ste 302, Petaluma, CA 94954-6697 | 2013-07-16 |
| 1306183991 | Brian Kent Sibbald | Dentist | 255 Fairview Ct, Petaluma, CA 94952-1627 | 2013-01-16 |
| 1396912242 | Bailey Hudson Graham Iv | Dentist | 1126 B St, Petaluma, CA 94952-4055 | 2008-05-09 |
| 1104001015 | Suryamanga.d.achyuta,dds,inc | Dentist | 1372 N Mcdowell Blvd, Suite#b-1, Petaluma, CA 94954-1179 | 2008-01-09 |
| 1902008204 | David A Straub | Dentist | 511 Hayes Ln, Petaluma, CA 94952-4011 | 2007-05-31 |
| 1811106370 | Yvonne A Szyperski | Dentist | 1580 East Washington St, #101, Petaluma, CA 94954 | 2007-05-22 |
| 1750406013 | Nadia Navid | Dentist | 216 Howard St, Petaluma, CA 94952-2719 | 2007-03-19 |
| 1578697546 | Yolanda Marye Mangrum | Dentist | 1301 Southpoint Blvd Ste A, Petaluma, CA 94954-6858 | 2007-03-14 |
| 1912045444 | Negar Safapour | Dentist | 515 Hayes Ln, Petaluma, CA 94952-4011 | 2007-02-05 |
| Find all providers in PETALUMA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.