Provider Demographics
NPI:1255600888
Name:HASSANZADEH, ELNAZ (DDS)
Entity type:Individual
Prefix:DR
First Name:ELNAZ
Middle Name:
Last Name:HASSANZADEH
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 SACRAMENTO STREET
Mailing Address - Street 2:APT 1404
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115
Mailing Address - Country:US
Mailing Address - Phone:415-613-8474
Mailing Address - Fax:
Practice Address - Street 1:2200 SACRAMENTO STREET
Practice Address - Street 2:APT 1404
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115
Practice Address - Country:US
Practice Address - Phone:415-613-8474
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-28
Last Update Date:2011-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA60823122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist