Provider Demographics
NPI:1255058442
Name:HASSANI AND NGO PEDIATRIC DENTAL PARTNERSHIP
Entity type:Organization
Organization Name:HASSANI AND NGO PEDIATRIC DENTAL PARTNERSHIP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HANIEH
Authorized Official - Middle Name:
Authorized Official - Last Name:HASSANI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MSD
Authorized Official - Phone:310-968-5574
Mailing Address - Street 1:1202 BRISTOL ST STE 140
Mailing Address - Street 2:
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92626-8606
Mailing Address - Country:US
Mailing Address - Phone:712-477-2906
Mailing Address - Fax:
Practice Address - Street 1:1202 BRISTOL ST STE 140
Practice Address - Street 2:
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92626-8606
Practice Address - Country:US
Practice Address - Phone:712-477-2906
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-27
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty