Provider Demographics
NPI:1710269675
Name:HAKIMIAN, EDWIN (DMD)
Entity Type:Individual
Prefix:DR
First Name:EDWIN
Middle Name:
Last Name:HAKIMIAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1635 N VICTORY PL
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91502-1645
Mailing Address - Country:US
Mailing Address - Phone:818-565-0057
Mailing Address - Fax:
Practice Address - Street 1:1635 N VICTORY PL
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91502-1645
Practice Address - Country:US
Practice Address - Phone:818-565-0057
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-15
Last Update Date:2017-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD0083181223G0001X
CA641811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice