Provider Demographics
NPI:1588748362
Name:SAHAR W TAWFIK DDS INC
Entity type:Organization
Organization Name:SAHAR W TAWFIK DDS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SAHAR
Authorized Official - Middle Name:W
Authorized Official - Last Name:TAWFIK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:650-917-9603
Mailing Address - Street 1:601 VAN NESS AVENUE
Mailing Address - Street 2:SUITE 2020
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94102
Mailing Address - Country:US
Mailing Address - Phone:415-441-4933
Mailing Address - Fax:415-441-4933
Practice Address - Street 1:601 VAN NESS AVENUE
Practice Address - Street 2:SUITE 2020
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102
Practice Address - Country:US
Practice Address - Phone:415-441-4933
Practice Address - Fax:415-441-4933
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SAHAR W TAWFIK DDS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-25
Last Update Date:2011-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA425021223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA000042502OtherDELTA DENTAL
0005934416OtherAETNA
CA011888OtherDELTA CARE
CADA0254360OtherBLUE SHIELD OF CALIFORNIA