Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. JIRIES PETER MOGANNAM, D.D.S., M.D.
Active Sole ProprietorDR. JIRIES PETER MOGANNAM, D.D.S., M.D. is a Oral & Maxillofacial Surgery healthcare provider located in SANTA ROSA, California. NPI 1609056878 is currently active in the NPPES registry. Verify at CMS.
Oral & Maxillofacial Surgery · SANTA ROSA, CA
Registration Details
- NPI Number
- 1609056878
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Nov 5, 2007 (18.731067205097 yrs)
- Last Updated
- Aug 17, 2011
- Licenses
-
60191 (CA)A114965 (CA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
1111 SONOMA AVESUITE #220SANTA ROSA, CA, 954054819Browse CA providers · Browse ZIP 95405
- Phone
- 7075667300
- Primary Specialty
-
Oral & Maxillofacial Surgery
1223S0112X
- Additional Specialty
- Oral & Maxillofacial Surgery (Physician)
Other Oral & Maxillofacial Surgery Providers in SANTA ROSA, CA
| Name | Credential | NPI |
|---|---|---|
| DR. PAUL J TIERNAN | DDS | 1942309877 |
| PAUL VINCENT SEJUD | DMD | 1881779387 |
| PEYMAN HEDAYATI | DDS,MD | 1336210095 |
| DR. ROBERT ELTON JARVIS II | DDS | 1275659336 |
| MR. MICHAEL F HOEY | — | 1447475363 |
| CHRISTOPHER SEAN DANIEL | DDS, MD | 1285899211 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.