Provider Demographics
NPI:1104267475
Name:MAHMOOD, TRUSKA SABIR (DDS)
Entity type:Individual
Prefix:
First Name:TRUSKA
Middle Name:SABIR
Last Name:MAHMOOD
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6475 ALVARADO RD STE 205
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92120-5013
Mailing Address - Country:US
Mailing Address - Phone:619-287-0990
Mailing Address - Fax:
Practice Address - Street 1:6475 ALVARADO RD STE 205
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92120
Practice Address - Country:US
Practice Address - Phone:619-287-0990
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-15
Last Update Date:2018-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADDS1002571223P0221X
CO002020201223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry