Healthcare Provider Details

I. General information

NPI: 1760955447
Provider Name (Legal Business Name): SAHAR DADVAND DDS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/06/2019
Last Update Date: 01/06/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

591 CLIPPER ST
SAN FRANCISCO CA
94114-3604
US

IV. Provider business mailing address

591 CLIPPER ST
SAN FRANCISCO CA
94114-3604
US

V. Phone/Fax

Practice location:
  • Phone: 415-793-9002
  • Fax:
Mailing address:
  • Phone: 415-793-9002
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number
License Number State

VIII. Authorized Official

Name: DR. SAHAR DADVAND
Title or Position: CEO/ENDODONTIC SPECIALTY
Credential: DDS
Phone: 415-793-9002