Provider Demographics
NPI:1396803342
Name:ALBIK, MOHAMAD TAISIR (DDS,AFAAID)
Entity type:Individual
Prefix:DR
First Name:MOHAMAD
Middle Name:TAISIR
Last Name:ALBIK
Suffix:
Gender:M
Credentials:DDS,AFAAID
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4944 WINDPLAY DR STE 301
Mailing Address - Street 2:
Mailing Address - City:EL DORADO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:95762-9310
Mailing Address - Country:US
Mailing Address - Phone:530-444-4944
Mailing Address - Fax:530-404-0444
Practice Address - Street 1:4944 WINDPLAY DR STE 301
Practice Address - Street 2:
Practice Address - City:EL DORADO HILLS
Practice Address - State:CA
Practice Address - Zip Code:95762-9310
Practice Address - Country:US
Practice Address - Phone:530-444-4944
Practice Address - Fax:530-444-4944
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2018-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA52577122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist