Provider Demographics
NPI:1417397753
Name:DAVID L HAKIM DDS PA
Entity type:Organization
Organization Name:DAVID L HAKIM DDS PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:L
Authorized Official - Last Name:HAKIM
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:310-993-5147
Mailing Address - Street 1:6565 MCCALLUM BLVD
Mailing Address - Street 2:#396
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75252-7002
Mailing Address - Country:US
Mailing Address - Phone:310-993-5147
Mailing Address - Fax:
Practice Address - Street 1:8226 DOUGLAS AVE
Practice Address - Street 2:SUITE 836
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75225-5943
Practice Address - Country:US
Practice Address - Phone:214-810-3532
Practice Address - Fax:214-368-6205
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-01
Last Update Date:2013-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX26333261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental