Provider Demographics
NPI:1215119060
Name:FIROZ HAKAKHA DDS INC
Entity type:Organization
Organization Name:FIROZ HAKAKHA DDS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FIROZ
Authorized Official - Middle Name:
Authorized Official - Last Name:HAKAKHA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:562-599-6600
Mailing Address - Street 1:1183 E ANAHEIM ST
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90813-3662
Mailing Address - Country:US
Mailing Address - Phone:562-599-6600
Mailing Address - Fax:562-218-5596
Practice Address - Street 1:1183 E ANAHEIM ST
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90813-3662
Practice Address - Country:US
Practice Address - Phone:562-599-6600
Practice Address - Fax:562-218-5596
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FIROZ HAKAKHA DDS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-12-04
Last Update Date:2007-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA39002122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty