Provider Demographics
NPI:1245355593
Name:MONEIM, ADAM A (DDS)
Entity type:Individual
Prefix:DR
First Name:ADAM
Middle Name:A
Last Name:MONEIM
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:AHMED
Other - Middle Name:ABDEL
Other - Last Name:MONEIM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:281 PENN WAY
Mailing Address - Street 2:
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95032-2617
Mailing Address - Country:US
Mailing Address - Phone:415-786-1289
Mailing Address - Fax:408-354-7433
Practice Address - Street 1:220 OAK MEADOW DR
Practice Address - Street 2:
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-4407
Practice Address - Country:US
Practice Address - Phone:408-354-7333
Practice Address - Fax:408-354-7433
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA455931223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice