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General NPI Number Information
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NPI Number | 1508530205
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Entity Type | Individual
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Provider Name | MAHEEN KIBRIYA DMD
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Gender | Female
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Dates
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Enumeration Date | 08/05/2021
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Last Update Date | 09/20/2022
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Provider Practice Location Address
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Address Line | 468 W SIERRA MADRE BLVD
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City | SIERRA MADRE
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State | CA
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Zip | 91024-2314
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Country | US
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Telephone | 626-355-0467
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Fax |
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Provider Business Mailing Address
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Address Line | 27661 COUNTRY LANE RD
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City | LAGUNA NIGUEL
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State | CA
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Zip | 92677-3800
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 106791
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License Number State | CA
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