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NPI Code Detail

MEDICARE: MOZHGAN KIMBLE DDS

MEDICARE: MOZHGAN KIMBLE DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice DentistryD04697AZ
2122300000XDentist4697AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1205087228
Entity Type Code : Individual
Provider Name (Legal Business Name) : MOZHGAN KIMBLE DDS
Provider Business Mailing Address
First Line : 7500 N DREAMY DRAW DR STE 145
Second Line :
City : PHOENIX
State : AZ
Zip : 85020-4668
Country : US
Telephone Number : 480-882-4545
Fax Number : 480-882-5814
Provider Business Practice Location Address
First Line : 9015 N 3RD ST
Second Line :
City : PHOENIX
State : AZ
Zip : 85020-2444
Country : US
Telephone Number : 480-882-4545
Fax Number : 602-870-6348
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/08/2008
Last Update Date : 01/20/2023

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Directions to “ MOZHGAN KIMBLE DDS” Practice Location

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