Healthcare Provider Details

I. General information

NPI: 1083266035
Provider Name (Legal Business Name): NICOLE ALEA SARMIENTO HAMAMOTO DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DR. NICOLE ALEA SARMIENTO

II. Dates (important events)

Enumeration Date: 07/10/2019
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1821 W AVENUE I STE 101
LANCASTER CA
93534-1468
US

IV. Provider business mailing address

1821 W AVENUE I STE 101
LANCASTER CA
93534-1468
US

V. Phone/Fax

Practice location:
  • Phone: 661-729-1818
  • Fax:
Mailing address:
  • Phone: 661-729-1818
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number103978
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: