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General NPI Number Information
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NPI Number | 1114474392
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Entity Type | Organization
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Legal Business Name | YASAMAN SANI DDS INC.
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Dates
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Enumeration Date | 09/06/2016
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Last Update Date | 09/06/2016
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Provider Practice Location Address
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Address Line | 4125 CONCORD BLVD. SUITE A
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City | CONCORD
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State | CA
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Zip | 94519
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Country | US
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Telephone | 925-849-4469
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Fax | 925-849-4697
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Provider Business Mailing Address
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Address Line | 4125 CONCORD BLVD. SUITE A
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City | CONCORD
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State | CA
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Zip | 94519
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Country | US
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Telephone | 925-849-4469
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Fax | 925-849-4697
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Authorized Official
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Title or Position | CEO
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Name | DR. YASMAN SANI
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Credential | DDS
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Telephone | 925-588-4294
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 53029
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License Number State | CA
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