Provider Demographics
NPI:1902564073
Name:HANGAMA KAZEM SADAT DDS, INC.
Entity Type:Organization
Organization Name:HANGAMA KAZEM SADAT DDS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HANGAMA
Authorized Official - Middle Name:KAZEM
Authorized Official - Last Name:SADAT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:619-420-2231
Mailing Address - Street 1:333 H ST STE 1015
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91910-5556
Mailing Address - Country:US
Mailing Address - Phone:619-420-2231
Mailing Address - Fax:
Practice Address - Street 1:333 H ST STE 1015
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91910-5556
Practice Address - Country:US
Practice Address - Phone:619-420-2231
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-06
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty