Provider Demographics
NPI:1801490826
Name:SEPAND H HOKMABADI DENTAL CORPORATION
Entity type:Organization
Organization Name:SEPAND H HOKMABADI DENTAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SEPAN D
Authorized Official - Middle Name:
Authorized Official - Last Name:HOKMABADI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:510-907-4440
Mailing Address - Street 1:4041 ALHAMBRA AVE STE 109
Mailing Address - Street 2:
Mailing Address - City:MARTINEZ
Mailing Address - State:CA
Mailing Address - Zip Code:94553-3827
Mailing Address - Country:US
Mailing Address - Phone:510-907-4440
Mailing Address - Fax:
Practice Address - Street 1:4041 ALHAMBRA AVE STE 109
Practice Address - Street 2:
Practice Address - City:MARTINEZ
Practice Address - State:CA
Practice Address - Zip Code:94553-3827
Practice Address - Country:US
Practice Address - Phone:510-907-4440
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-30
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental