Provider Demographics
NPI:1982937850
Name:AGHAKHAN-MOHEB, AHMAD (DDS)
Entity Type:Individual
Prefix:
First Name:AHMAD
Middle Name:
Last Name:AGHAKHAN-MOHEB
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27654 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 1:65 RABANO
Practice Address - Street 2:
Practice Address - City:RANCHO SANTA MARGARITA
Practice Address - State:CA
Practice Address - Zip Code:92688-4962
Practice Address - Country:US
Practice Address - Phone:818-486-4573
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-10
Last Update Date:2016-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA588091223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice