Provider Demographics
NPI:1508982190
Name:HASAN AND HOSSEINI DDS CORPORATION
Entity Type:Organization
Organization Name:HASAN AND HOSSEINI DDS CORPORATION
Other - Org Name:DEVONSHIRE DENTAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SYED
Authorized Official - Middle Name:M
Authorized Official - Last Name:HASAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:818-894-6411
Mailing Address - Street 1:15300 DEVONSHIRE ST
Mailing Address - Street 2:#6
Mailing Address - City:MISSION HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91345-2781
Mailing Address - Country:US
Mailing Address - Phone:818-894-6411
Mailing Address - Fax:818-830-5283
Practice Address - Street 1:15300 DEVONSHIRE ST
Practice Address - Street 2:#6
Practice Address - City:MISSION HILLS
Practice Address - State:CA
Practice Address - Zip Code:91345-2781
Practice Address - Country:US
Practice Address - Phone:818-894-6411
Practice Address - Fax:818-830-5283
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA470861223G0001X
CA530681223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty