| Apple Dental Center | |
|
19190 Us Highway 18 Suite A Apple Valley CA 92307-2558 | |
| (760) 242-7753 | |
| (760) 946-1122 |
| Full Name | Apple Dental Center |
|---|---|
| Speciality | Dentist |
| Location | 19190 Us Highway 18, Apple Valley, California |
| Authorized Official Name and Position | Farhad Mazi (PRESIDENT DENTIST) |
| Authorized Official Contact | 7602427753 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Apple Dental Center 19190 Us Highway 18 Suite A Apple Valley CA 92307-2558 Ph: (760) 242-7753 | Apple Dental Center 19190 Us Highway 18 Suite A Apple Valley CA 92307-2558 Ph: (760) 242-7753 |
| NPI Number | 1063543577 |
|---|---|
| Provider Enumeration Date | 03/08/2007 |
| Last Update Date | 07/01/2015 |
| Medicare PECOS PAC ID | 3476864406 |
|---|---|
| Medicare Enrollment ID | O20150617002828 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063543577 | NPI | - | NPPES |
| G89141-01 | Medicaid | CA | |
| G92354-01 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 48832 (California) | Primary |
| Provider Name | Farhad Mazi |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1730244476 PECOS PAC ID: 4385955319 Enrollment ID: I20150818003311 |
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