Provider Demographics
NPI:1083421960
Name:H & S HANASAB DENTAL CORPORATION
Entity type:Organization
Organization Name:H & S HANASAB DENTAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HOMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HANASAB
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:310-892-6631
Mailing Address - Street 1:3470 WILSHIRE BLVD STE 450
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90010-3946
Mailing Address - Country:US
Mailing Address - Phone:213-386-3348
Mailing Address - Fax:
Practice Address - Street 1:3470 WILSHIRE BLVD STE 450
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90010-3946
Practice Address - Country:US
Practice Address - Phone:213-386-3348
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-14
Last Update Date:2024-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty