Healthcare Provider Details

I. General information

NPI: 1659062354
Provider Name (Legal Business Name): SAMADIAN DENTAL CARE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2023
Last Update Date: 10/04/2026
Certification Date: 10/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

260 STOCKTON ST FL 4
SAN FRANCISCO CA
94108-5317
US

IV. Provider business mailing address

3503 WILD FLOWER WAY
CONCORD CA
94518-2329
US

V. Phone/Fax

Practice location:
  • Phone: 415-392-5025
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number StateNULL

VIII. Authorized Official

Name: AMIN SAMADIAN
Title or Position: CEO
Credential:
Phone: 415-676-7420