Provider Demographics
NPI:1356019863
Name:DENTAL CORPORATION OF SEPAND HOKMABADI
Entity Type:Organization
Organization Name:DENTAL CORPORATION OF SEPAND HOKMABADI
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SEPAND
Authorized Official - Middle Name:
Authorized Official - Last Name:HOKMABADI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:510-929-4944
Mailing Address - Street 1:300 FRANK H OGAWA PLZ STE 100
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94612-2069
Mailing Address - Country:US
Mailing Address - Phone:510-929-4944
Mailing Address - Fax:510-929-4944
Practice Address - Street 1:300 FRANK H OGAWA PLZ STE 100
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94612-2069
Practice Address - Country:US
Practice Address - Phone:510-929-4944
Practice Address - Fax:510-929-4944
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-31
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty