Healthcare Provider Details

I. General information

NPI: 1356253348
Provider Name (Legal Business Name): SUNNYVALE SMILE CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 W EL CAMINO REAL STE 65
MOUNTAIN VIEW CA
94040-2649
US

IV. Provider business mailing address

100 W EL CAMINO REAL STE 65
MOUNTAIN VIEW CA
94040-2649
US

V. Phone/Fax

Practice location:
  • Phone: 408-730-4064
  • Fax: 408-730-5520
Mailing address:
  • Phone: 408-730-4064
  • Fax: 408-730-5520

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: IYAD BAKDACH
Title or Position: DOCTOR
Credential: DDS
Phone: 408-730-4064