Provider Demographics
NPI:1841635158
Name:SEAN HAKIMI DDS A PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:SEAN HAKIMI DDS A PROFESSIONAL CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:HILDA
Authorized Official - Middle Name:
Authorized Official - Last Name:LOTFI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-458-9550
Mailing Address - Street 1:47 MARIA DR STE 813
Mailing Address - Street 2:
Mailing Address - City:PETALUMA
Mailing Address - State:CA
Mailing Address - Zip Code:94954-3566
Mailing Address - Country:US
Mailing Address - Phone:707-763-3203
Mailing Address - Fax:
Practice Address - Street 1:47 MARIA DR STE 813
Practice Address - Street 2:
Practice Address - City:PETALUMA
Practice Address - State:CA
Practice Address - Zip Code:94954-3566
Practice Address - Country:US
Practice Address - Phone:707-763-3203
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-01
Last Update Date:2013-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty