Provider Demographics
NPI:1174688295
Name:HAMED JAVADI D.D.S., M.S., INC.
Entity Type:Organization
Organization Name:HAMED JAVADI D.D.S., M.S., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HAMED
Authorized Official - Middle Name:
Authorized Official - Last Name:JAVADI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:415-392-1265
Mailing Address - Street 1:450 SUTTER ST RM 2018
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94108-4104
Mailing Address - Country:US
Mailing Address - Phone:415-392-1265
Mailing Address - Fax:415-392-1267
Practice Address - Street 1:1615 HILL RD STE 4
Practice Address - Street 2:
Practice Address - City:NOVATO
Practice Address - State:CA
Practice Address - Zip Code:94947-4304
Practice Address - Country:US
Practice Address - Phone:415-898-6660
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-27
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA504131223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty