Provider Demographics
NPI:1235845538
Name:HAKIMZADEH AND REYHANI DENTAL OFFICE OF PICO LAWNDALE INC
Entity Type:Organization
Organization Name:HAKIMZADEH AND REYHANI DENTAL OFFICE OF PICO LAWNDALE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUDITOR
Authorized Official - Prefix:
Authorized Official - First Name:CAROLINA
Authorized Official - Middle Name:
Authorized Official - Last Name:NAPOLES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-688-3852
Mailing Address - Street 1:15228 HAWTHORNE BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:LAWNDALE
Mailing Address - State:CA
Mailing Address - Zip Code:90260-2268
Mailing Address - Country:US
Mailing Address - Phone:310-220-0456
Mailing Address - Fax:
Practice Address - Street 1:15228 HAWTHORNE BLVD STE A
Practice Address - Street 2:
Practice Address - City:LAWNDALE
Practice Address - State:CA
Practice Address - Zip Code:90260-2268
Practice Address - Country:US
Practice Address - Phone:310-220-0456
Practice Address - Fax:562-381-8187
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-30
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1376790907OtherDENTAL OFFICE