Provider Demographics
NPI:1376943647
Name:FRANK HACKMAN DDS. INC
Entity Type:Organization
Organization Name:FRANK HACKMAN DDS. INC
Other - Org Name:ALL FAMILY DENTAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DR
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:HACKMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:818-709-9988
Mailing Address - Street 1:8864 CORBIN AVE
Mailing Address - Street 2:
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91324-3309
Mailing Address - Country:US
Mailing Address - Phone:818-709-9988
Mailing Address - Fax:818-709-7930
Practice Address - Street 1:8864 CORBIN AVE
Practice Address - Street 2:
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91324-3309
Practice Address - Country:US
Practice Address - Phone:818-709-9988
Practice Address - Fax:818-709-7930
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-24
Last Update Date:2014-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA45463122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA45463Medicaid