Healthcare Provider Details

I. General information

NPI: 1912847625
Provider Name (Legal Business Name): DIMA MOHAMED S ABU BAKER DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/31/2026
Last Update Date: 03/31/2026
Certification Date: 03/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 5TH ST
SAN FRANCISCO CA
94103-2919
US

IV. Provider business mailing address

155 5TH ST CUBICLE 4D17
SAN FRANCISCO CA
94103-2919
US

V. Phone/Fax

Practice location:
  • Phone: 415-312-0690
  • Fax:
Mailing address:
  • Phone: 415-312-0690
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberSP333
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: