Healthcare Provider Details

I. General information

NPI: 1063323517
Provider Name (Legal Business Name): MOURUSHEE CHOWDHURY DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27140 EUCALYPTUS AVE STE C
MORENO VALLEY CA
92555-4545
US

IV. Provider business mailing address

1201 S HOPE ST APT 1717
LOS ANGELES CA
90015-4715
US

V. Phone/Fax

Practice location:
  • Phone: 951-336-8478
  • Fax:
Mailing address:
  • Phone: 301-979-2843
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number113565
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: