Provider Demographics
NPI:1639515752
Name:HAKIM DENTAL GROUP
Entity Type:Organization
Organization Name:HAKIM DENTAL GROUP
Other - Org Name:SMILES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:MAHSA
Authorized Official - Middle Name:
Authorized Official - Last Name:HAKIM
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:415-693-9139
Mailing Address - Street 1:450 SUTTER ST RM 1326
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94108-4007
Mailing Address - Country:US
Mailing Address - Phone:415-693-9139
Mailing Address - Fax:
Practice Address - Street 1:450 SUTTER ST RM 1326
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94108-4007
Practice Address - Country:US
Practice Address - Phone:415-693-9139
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-15
Last Update Date:2013-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA529871223D0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223D0001XDental ProvidersDentistDental Public HealthGroup - Single Specialty