MEDICARE: DR. MOHAMMAD NOMANI D.D.S.

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
1	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	60921	KS

General Provider Information

NPI Number	:	1699099465
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MOHAMMAD NOMANI D.D.S.

Provider Business Mailing Address
First Line	:	4201 ANDERSON AVE
Second Line	:	STE E
City	:	MANHATTAN
State	:	KS
Zip	:	66503
Country	:	US
Telephone Number	:	785-539-7429
Fax Number	:	785-539-5320

Provider Business Practice Location Address
First Line	:	4201 ANDERSON AVE STE E
Second Line	:
City	:	MANHATTAN
State	:	KS
Zip	:	66503-7603
Country	:	US
Telephone Number	:	785-539-7429
Fax Number	:	785-539-5320

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/22/2010
Last Update Date	:	07/21/2022

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