MEDICARE: OMAR MOUSSA, DDS, INC

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	122300000X	Dentist

General Provider Information

NPI Number	:	1770473027
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OMAR MOUSSA, DDS, INC

Provider Business Mailing Address
First Line	:	2160 S BEVERLY GLEN BLVD APT 226
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90025-6036
Country	:	US
Telephone Number	:	213-394-5522
Fax Number	:

Provider Business Practice Location Address
First Line	:	2160 S BEVERLY GLEN BLVD APT 226
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90025-6036
Country	:	US
Telephone Number	:	213-394-5522
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. OMAR MOUSSA
Credential	:	DDS
Telephone Number	:	213-394-5522

Provider Enumeration Date	:	07/08/2025
Last Update Date	:	03/26/2026

Similar Medicare Providers

1497645717 — DR. OMAR MOUSSA DDS
Practice Location Address:

2160 S BEVERLY GLEN BLVD APT 226
LOS ANGELES, CA
90025-6036

Practice Phone: 213-394-5522
Practice Fax:

1558615245 — INSULWON ACUPUNCTURE INC.
Practice Location Address:

1716 CRENSHAW BLVD
LOS ANGELES, CA
90019-6036

Practice Phone: 323-317-1725
Practice Fax:

1871282046 — BLISSFUL BABY DOULA SERVICES
Practice Location Address:

1748 1/2 CRENSHAW BLVD
LOS ANGELES, CA
90019-6036

Practice Phone: 323-633-4577
Practice Fax:

1407546690 — CHARLYNE CATHERINE ALVARADO
Practice Location Address:

1748 1/2 CRENSHAW BLVD
LOS ANGELES, CA
90019-6036

Practice Phone: 323-633-4577
Practice Fax:

1861820763 — MAUREEN DONLEY MFT
Practice Location Address:

2001 S BARRINGTON AVE
LOS ANGELES, CA
90025-5363

Practice Phone: 310-359-6036
Practice Fax: 815-717-7625

1962340604 — ALEXANDRIA NICOLE FERNANDEZ M.A., APCC
Practice Location Address:

1642 FEDERAL AVE APT 302
LOS ANGELES, CA
90025-6697

Practice Phone: 310-862-2436
Practice Fax:

Directions to “OMAR MOUSSA, DDS, INC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.