Provider Demographics
NPI:1326322009
Name:MEHREGAN, ROUHINA (DDS)
Entity Type:Individual
Prefix:
First Name:ROUHINA
Middle Name:
Last Name:MEHREGAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4673 RIVERSIDE DR STE D
Mailing Address - Street 2:
Mailing Address - City:CHINO
Mailing Address - State:CA
Mailing Address - Zip Code:91710-5905
Mailing Address - Country:US
Mailing Address - Phone:909-627-7977
Mailing Address - Fax:
Practice Address - Street 1:4673 RIVERSIDE DR STE D
Practice Address - Street 2:
Practice Address - City:CHINO
Practice Address - State:CA
Practice Address - Zip Code:91710-5905
Practice Address - Country:US
Practice Address - Phone:909-627-7977
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-29
Last Update Date:2022-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVLL-244-111223G0001X
CA623101223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice