Healthcare Provider Details

I. General information

NPI: 1366370249
Provider Name (Legal Business Name): KARKHANEHCHI DDS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2026
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12677 ALCOSTA BLVD STE 575
SAN RAMON CA
94583-4423
US

IV. Provider business mailing address

4645 KINGSWOOD DR
DANVILLE CA
94506-6037
US

V. Phone/Fax

Practice location:
  • Phone: 925-829-1100
  • Fax:
Mailing address:
  • Phone: 415-612-0256
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. HENGAMEH KARKHANECHI
Title or Position: OWNER
Credential: DDS
Phone: 415-612-0256