Individual ProviderMina AbdullahDentistDental ProvidersPractice Address767 Jamacha Rd, El Cajon, CA 92019-3202(619) 767-8039PECOS EnrollmentBased on the most recent information from CMS, provider Mina Abdullah does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1710393327Provider TypeIndividualFull NameAbdullah, MinaCredentialDDSGenderFemaleSole ProprietorYesEnumeration Date7/2/2014Last Updated3/14/2019Contact InformationPractice LocationPractice Address767 Jamacha Rd, El Cajon, CA 92019-3202Phone(619) 767-8039FaxUnlisted FaxMailing LocationMailing Address11051 Camino Playa Carmel, San Diego, CA 92124-4140Phone(619) 767-8039FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode1223G0001XPrimaryDescriptionDentistDental ProvidersLicense65266CaliforniaCode122300000XDescriptionDentistDental ProvidersLicense30212Texas