Provider Demographics
NPI:1942339064
Name:HAKIMIAN, HERTSEL PERJAM (DDS)
Entity Type:Individual
Prefix:
First Name:HERTSEL
Middle Name:PERJAM
Last Name:HAKIMIAN
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 1:5 GALANTO
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92614-5372
Mailing Address - Country:US
Mailing Address - Phone:949-387-8977
Mailing Address - Fax:
Practice Address - Street 1:8381 LA PALMA AVE
Practice Address - Street 2:
Practice Address - City:BUENA PARK
Practice Address - State:CA
Practice Address - Zip Code:90620-3271
Practice Address - Country:US
Practice Address - Phone:714-228-9990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA406041223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice