Provider Demographics
NPI:1972744852
Name:HADIAN & SADRI, DDS, INC
Entity type:Organization
Organization Name:HADIAN & SADRI, DDS, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARYAM
Authorized Official - Middle Name:
Authorized Official - Last Name:HADIAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:310-513-0222
Mailing Address - Street 1:23517 MAIN ST
Mailing Address - Street 2:SUITE 106
Mailing Address - City:CARSON
Mailing Address - State:CA
Mailing Address - Zip Code:90745-5251
Mailing Address - Country:US
Mailing Address - Phone:310-513-0222
Mailing Address - Fax:310-513-1352
Practice Address - Street 1:23517 MAIN ST
Practice Address - Street 2:SUITE 106
Practice Address - City:CARSON
Practice Address - State:CA
Practice Address - Zip Code:90745-5251
Practice Address - Country:US
Practice Address - Phone:310-513-0222
Practice Address - Fax:310-513-1352
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-23
Last Update Date:2009-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA52609302F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization