Provider Demographics
NPI:1841447778
Name:HAKIMIZADEH, BABAK (DMD)
Entity type:Individual
Prefix:
First Name:BABAK
Middle Name:
Last Name:HAKIMIZADEH
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:323 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WEST HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06516-4424
Mailing Address - Country:US
Mailing Address - Phone:203-937-7181
Mailing Address - Fax:
Practice Address - Street 1:27 HOSPITAL AVE STE 306
Practice Address - Street 2:
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06810-5961
Practice Address - Country:US
Practice Address - Phone:203-797-0008
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-21
Last Update Date:2023-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0107011223S0112X
NY0630591223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery