Provider Demographics
NPI:1013160530
Name:S. HAKIMI, DDS A PROFESSIONAL CORP
Entity Type:Organization
Organization Name:S. HAKIMI, DDS A PROFESSIONAL CORP
Other - Org Name:STOCKTON DENTAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SOHAIL
Authorized Official - Middle Name:SEAN
Authorized Official - Last Name:HAKIMI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:661-255-3130
Mailing Address - Street 1:PO BOX 55368
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91385-0368
Mailing Address - Country:US
Mailing Address - Phone:661-255-3130
Mailing Address - Fax:661-255-3020
Practice Address - Street 1:1036 W ROBINHOOD DR STE 104
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95207-5622
Practice Address - Country:US
Practice Address - Phone:209-956-9650
Practice Address - Fax:209-956-9655
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-28
Last Update Date:2008-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA39643261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental