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NPI Code Detail

MEDICARE: AZHAR AL-MOZANI DMD

MEDICARE: AZHAR AL-MOZANI DMD
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
1390200000XStudent in an Organized Health Care Education/Training ProgramDS044208PA
2122300000XDentistDS044208PA

General Provider Information

NPI Number : 1396423828
Entity Type Code : Individual
Provider Name (Legal Business Name) : AZHAR AL-MOZANI DMD
Provider Business Mailing Address
First Line : 211 GEIGER RD
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19115-1009
Country : US
Telephone Number : 415-936-6863
Fax Number :
Provider Business Practice Location Address
First Line : 160 E ERIE AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19134-1011
Country : US
Telephone Number : 415-936-6863
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/05/2023
Last Update Date : 01/22/2026

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Directions to “ AZHAR AL-MOZANI DMD” Practice Location

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