Healthcare Provider Details

I. General information

NPI: 1588185516
Provider Name (Legal Business Name): MOKBIL DENTAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2017
Last Update Date: 03/08/2022
Certification Date: 03/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4022 SUNRISE BLVD,. STE 160
RANCHO CORDOVA CA
95742
US

IV. Provider business mailing address

PO BOX 920050
DALLAS TX
75392-0050
US

V. Phone/Fax

Practice location:
  • Phone: 916-246-1108
  • Fax: 916-668-6890
Mailing address:
  • Phone: 714-845-8500
  • Fax: 949-474-1495

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VIII. Authorized Official

Name: AHMAD MOKBIL
Title or Position: OWNER
Credential: DMD
Phone: 916-246-1108