Healthcare Provider Details

I. General information

NPI: 1588748362
Provider Name (Legal Business Name): SAHAR W TAWFIK DDS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2006
Last Update Date: 12/06/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 VAN NESS AVENUE SUITE 2020
SAN FRANCISCO CA
94102
US

IV. Provider business mailing address

601 VAN NESS AVENUE SUITE 2020
SAN FRANCISCO CA
94102
US

V. Phone/Fax

Practice location:
  • Phone: 415-441-4933
  • Fax: 415-441-4933
Mailing address:
  • Phone: 415-441-4933
  • Fax: 415-441-4933

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number42502
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number42502
License Number StateCA

VIII. Authorized Official

Name: DR. SAHAR W TAWFIK
Title or Position: OWNER
Credential:
Phone: 650-917-9603