Provider Demographics
NPI:1841431566
Name:SADEGHI, MOHAMMAD HASSAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:MOHAMMAD
Middle Name:HASSAN
Last Name:SADEGHI
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 1:43 PEBBLE BEACH DR
Mailing Address - Street 2:
Mailing Address - City:APTOS
Mailing Address - State:CA
Mailing Address - Zip Code:95003-5725
Mailing Address - Country:US
Mailing Address - Phone:831-464-3011
Mailing Address - Fax:831-685-2408
Practice Address - Street 1:43 PEBBLE BEACH DR
Practice Address - Street 2:
Practice Address - City:APTOS
Practice Address - State:CA
Practice Address - Zip Code:95003-5725
Practice Address - Country:US
Practice Address - Phone:831-464-3011
Practice Address - Fax:831-685-2408
Is Sole Proprietor?:No
Enumeration Date:2009-03-09
Last Update Date:2013-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA426031223D0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223D0004XDental ProvidersDentistDentist Anesthesiologist