Individual
DR. IDEAN K MOHAMMADI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
510 S DUCK ST, STILLWATER, OK 74074-4051
(405) 377-7300
Mailing address
510 S DUCK ST, STILLWATER, OK 74074-4051
(405) 377-7300
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2022019328
MO
122300000X
Dentist
61881
KS
122300000X
Dentist
Primary
7984
OK
Other
Enumeration date
10/14/2022
Last updated
05/12/2026
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