Provider Demographics
NPI:1093922973
Name:AZEEM K. LAKHA, DMD, A.P.C.
Entity Type:Organization
Organization Name:AZEEM K. LAKHA, DMD, A.P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AZEEM
Authorized Official - Middle Name:K
Authorized Official - Last Name:LAKHA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:650-328-6622
Mailing Address - Street 1:720 COWPER ST
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94301
Mailing Address - Country:US
Mailing Address - Phone:650-328-6622
Mailing Address - Fax:650-328-9970
Practice Address - Street 1:720 COWPER ST
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94301
Practice Address - Country:US
Practice Address - Phone:650-328-6622
Practice Address - Fax:650-328-9970
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-17
Last Update Date:2008-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA341391223S0112X
CA362241223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty