Provider Demographics
NPI:1306423470
Name:SEPAND H HOKMABADI DENTAL CORPORATION
Entity type:Organization
Organization Name:SEPAND H HOKMABADI DENTAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING AMANGER
Authorized Official - Prefix:
Authorized Official - First Name:APRIL
Authorized Official - Middle Name:
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-907-4440
Mailing Address - Street 1:4041 ALHAMBRA AVE STE 109
Mailing Address - Street 2:
Mailing Address - City:MARTINEZ
Mailing Address - State:CA
Mailing Address - Zip Code:94553-3827
Mailing Address - Country:US
Mailing Address - Phone:510-907-4440
Mailing Address - Fax:510-587-9977
Practice Address - Street 1:4041 ALHAMBRA AVE STE 109
Practice Address - Street 2:
Practice Address - City:MARTINEZ
Practice Address - State:CA
Practice Address - Zip Code:94553-3827
Practice Address - Country:US
Practice Address - Phone:925-293-8956
Practice Address - Fax:510-587-9977
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SEPAND H HOKMABADI DENTAL CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-03-25
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty