Healthcare Provider Details

I. General information

NPI: 1336538016
Provider Name (Legal Business Name): FATEMEH MOORMEHEI D.D.S
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/17/2015
Last Update Date: 01/30/2026
Certification Date: 01/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2756 S ELM AVE
FRESNO CA
93706-5435
US

IV. Provider business mailing address

2756 S ELM AVE
FRESNO CA
93706-5435
US

V. Phone/Fax

Practice location:
  • Phone: 559-457-5345
  • Fax: 559-457-5395
Mailing address:
  • Phone: 559-457-5345
  • Fax: 559-457-5395

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number64306
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: