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NPI Code Detail

MEDICARE: ADIL SHAHBAZ MOGHUL DDS

MEDICARE: ADIL SHAHBAZ MOGHUL DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry2022017964MO
21223G0001XGeneral Practice Dentistry2022017694MO

General Provider Information

NPI Number : 1073250247
Entity Type Code : Individual
Provider Name (Legal Business Name) : ADIL SHAHBAZ MOGHUL DDS
Provider Business Mailing Address
First Line : 1437 GARDENA AVE NE
Second Line :
City : FRIDLEY
State : MN
Zip : 55432-5815
Country : US
Telephone Number : 612-558-4069
Fax Number :
Provider Business Practice Location Address
First Line : 319 NE VIVION RD
Second Line :
City : KANSAS CITY
State : MO
Zip : 64118-4510
Country : US
Telephone Number : 816-459-0000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/18/2022
Last Update Date : 09/13/2023

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Directions to “ ADIL SHAHBAZ MOGHUL DDS” Practice Location

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