Provider Demographics
NPI:1619464609
Name:HAKIMZADEH AND REYHANI DENTAL CORP
Entity Type:Organization
Organization Name:HAKIMZADEH AND REYHANI DENTAL CORP
Other - Org Name:PEARL DENTAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLER
Authorized Official - Prefix:
Authorized Official - First Name:CRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-925-3735
Mailing Address - Street 1:9426 SOMERSET BLVD
Mailing Address - Street 2:
Mailing Address - City:BELLFLOWER
Mailing Address - State:CA
Mailing Address - Zip Code:90706-3009
Mailing Address - Country:US
Mailing Address - Phone:562-925-3735
Mailing Address - Fax:562-381-9150
Practice Address - Street 1:2082 FOOTHILL BLVD
Practice Address - Street 2:
Practice Address - City:LA VERNE
Practice Address - State:CA
Practice Address - Zip Code:91750-3559
Practice Address - Country:US
Practice Address - Phone:909-596-5959
Practice Address - Fax:562-381-9150
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-16
Last Update Date:2018-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental