Healthcare Provider Details

I. General information

NPI: 1659562098
Provider Name (Legal Business Name): DELARAM HANOOKAI DDS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2007
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4312 WOODMAN AVE SUITE #100
SHERMAN OAKS CA
91423-5546
US

IV. Provider business mailing address

4312 WOODMAN AVE SUITE #100
SHERMAN OAKS CA
91423-5546
US

V. Phone/Fax

Practice location:
  • Phone: 818-788-8787
  • Fax: 818-788-4858
Mailing address:
  • Phone: 818-788-8787
  • Fax: 818-788-4858

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number41919
License Number StateCA

VIII. Authorized Official

Name: MRS. DELARAM HANOOKAI
Title or Position: DDS/OWNER
Credential:
Phone: 310-254-5275