Healthcare Provider Details

I. General information

NPI: 1154609840
Provider Name (Legal Business Name): SONA BEKMEZIAN DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2011
Last Update Date: 09/19/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

707 PARNASSUS AVE RM D1116
SAN FRANCISCO CA
94143-0753
US

IV. Provider business mailing address

707 PARNASSUS AVE RM D1116
SAN FRANCISCO CA
94143-0753
US

V. Phone/Fax

Practice location:
  • Phone: 415-514-1181
  • Fax: 415-514-0377
Mailing address:
  • Phone: 415-514-1181
  • Fax: 415-514-0377

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number59817
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number59817
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: