Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Jiries Peter Mogannam, DDS, MD

Individual provider Oral and Maxillofacial Surgery (Dentist) · NPI 1609056878

Dr. Jiries Peter Mogannam, DDS, MD is an Oral and Maxillofacial Surgery (Dentist) in Santa Rosa, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2007
Specialties on file
2
What do these letters mean?
DDS — Doctor of Dental Surgery
A dentist. DDS and DMD are the same qualification — universities choose which title to award.
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1111 Sonoma Ave Ste #220
Santa Rosa, CA 95405-4819
Phone: (707) 566-7300
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Oral and Maxillofacial Surgery (Dentist) (primary) Taxonomy 1223S0112X · Licence 60191 (CA)
Oral & Maxillofacial Surgery (D.M.D.) Taxonomy 204E00000X · Licence A114965 (CA)

Record details

NPI number1609056878
Entity typeIndividual (Type 1)
GenderMale
Credentials DDS , MD
Sole proprietorYes
NPI enumeratedNovember 5, 2007
Last updated in NPPESAugust 17, 2011

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