Healthcare Provider Details

I. General information

NPI: 1659228203
Provider Name (Legal Business Name): DINA MOUSSA MD, PHD, BDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/12/2026
Last Update Date: 03/12/2026
Certification Date: 03/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 5TH ST STE 412
SAN FRANCISCO CA
94103-2919
US

IV. Provider business mailing address

155 5TH ST STE 412
SAN FRANCISCO CA
94103-2919
US

V. Phone/Fax

Practice location:
  • Phone: 415-351-7173
  • Fax:
Mailing address:
  • Phone: 415-351-7173
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberSP331
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: