Basic Information
| Provider Information | |||||||||
| NPI: | 1952827461 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MOGRI | ||||||||
| FirstName: | RASHIDA | ||||||||
| MiddleName: | TAYEB | ||||||||
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| Credential: | DDS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 34374 QUARTZ TER | ||||||||
| Address2: | |||||||||
| City: | FREMONT | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945552986 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5103967534 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 40910 FREMONT BLVD | ||||||||
| Address2: | |||||||||
| City: | FREMONT | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945384375 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5107708133 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/16/2017 | ||||||||
| LastUpdateDate: | 08/16/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1223G0001X | DDS101588 | CA | Y | Dental Providers | Dentist | General Practice |
No ID Information.