Provider Demographics
NPI:1679813513
Name:SADAKIAN, ALBERT HAGOP (DDS)
Entity Type:Individual
Prefix:MR
First Name:ALBERT
Middle Name:HAGOP
Last Name:SADAKIAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 BIRCH ST
Mailing Address - Street 2:
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94062-1398
Mailing Address - Country:US
Mailing Address - Phone:650-363-8525
Mailing Address - Fax:650-363-8556
Practice Address - Street 1:114 BIRCH ST
Practice Address - Street 2:
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94062-1398
Practice Address - Country:US
Practice Address - Phone:650-363-8525
Practice Address - Fax:650-363-8556
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-28
Last Update Date:2013-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA31374122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist