Healthcare Provider Details

I. General information

NPI: 1427255900
Provider Name (Legal Business Name): ROKAYA SAAD DDS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/28/2007
Last Update Date: 06/02/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12009 GARFIELD AVE
SOUTH GATE CA
90280-7822
US

IV. Provider business mailing address

12009 GARFIELD AVE
SOUTH GATE CA
90280-7822
US

V. Phone/Fax

Practice location:
  • Phone: 562-630-7777
  • Fax: 562-630-2929
Mailing address:
  • Phone: 562-630-7777
  • Fax: 562-630-2929

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number42880
License Number StateCA

VIII. Authorized Official

Name: KHAMIS SAAD
Title or Position: MGR
Credential:
Phone: 562-630-7777