Healthcare Provider Details

I. General information

NPI: 1487587200
Provider Name (Legal Business Name): MICHELLE MOHAMMADI RDH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27365 JEFFERSON AVE # SUIESL-M
TEMECULA CA
92590-5692
US

IV. Provider business mailing address

37751 SILVER BREEZE CT
MURRIETA CA
92563-2748
US

V. Phone/Fax

Practice location:
  • Phone: 951-719-1199
  • Fax: 951-719-1128
Mailing address:
  • Phone: 951-719-1199
  • Fax: 951-719-1128

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License NumberRDH35839
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: