Provider Demographics
NPI:1578800959
Name:HAMLABADI, ROYA
Entity Type:Individual
Prefix:
First Name:ROYA
Middle Name:
Last Name:HAMLABADI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3685 S BASCOM AVE
Mailing Address - Street 2:APT 47
Mailing Address - City:CAMPBELL
Mailing Address - State:CA
Mailing Address - Zip Code:95008-7076
Mailing Address - Country:US
Mailing Address - Phone:408-916-8192
Mailing Address - Fax:
Practice Address - Street 1:3685 S BASCOM AVE
Practice Address - Street 2:APT 47
Practice Address - City:CAMPBELL
Practice Address - State:CA
Practice Address - Zip Code:95008-7076
Practice Address - Country:US
Practice Address - Phone:408-916-8192
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-06
Last Update Date:2013-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA407124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist