Greenville Rancheria
NPI 1164780573ActiveOrganization· Dentist· Red Bluff, CA
Dentist in Red Bluff, California, registered in NPPES in April 2012, part of Greenville Rancheria. The authorized official on file is Omar Dyab, DDS, Executive Medical Director.
Overview
| NPI | 1164780573 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | Greenville Rancheria |
| NPI issued | Apr 24, 2012 |
| Last updated in NPPES | Oct 2, 2026 |
| Certified by provider | Oct 2, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist Primary | 122300000X | 32161 | CA |
| Dentist | 122300000X | 56174 | CA |
| Dentist, General Practice | 1223G0001X | 59948 | CA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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