Provider Demographics
NPI:1457480402
Name:FOKAS, HILDA YACOUB (DDS)
Entity Type:Individual
Prefix:DR
First Name:HILDA
Middle Name:YACOUB
Last Name:FOKAS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:HILDA
Other - Middle Name:M
Other - Last Name:YACOUB
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:11985 4TH ST
Mailing Address - Street 2:STE 115
Mailing Address - City:YACAIPA
Mailing Address - State:CA
Mailing Address - Zip Code:92399
Mailing Address - Country:US
Mailing Address - Phone:909-797-1175
Mailing Address - Fax:909-790-2816
Practice Address - Street 1:11985 4TH ST
Practice Address - Street 2:STE 115
Practice Address - City:YACAIPA
Practice Address - State:CA
Practice Address - Zip Code:92399
Practice Address - Country:US
Practice Address - Phone:909-797-1175
Practice Address - Fax:909-790-2816
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2007-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA394991223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice