Provider Demographics
NPI:1225425945
Name:MOHEB DENTAL CORPORATION
Entity Type:Organization
Organization Name:MOHEB DENTAL CORPORATION
Other - Org Name:NEW GENERATION DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AHMAD
Authorized Official - Middle Name:
Authorized Official - Last Name:AGHAKHAN-MOHEB
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:818-486-4573
Mailing Address - Street 1:27654 SANTA MARGARITA PKWY
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-6674
Mailing Address - Country:US
Mailing Address - Phone:949-354-5620
Mailing Address - Fax:
Practice Address - Street 1:27654 SANTA MARGARITA PKWY
Practice Address - Street 2:
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-6674
Practice Address - Country:US
Practice Address - Phone:949-354-5620
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-21
Last Update Date:2015-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA58809122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty