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General NPI Number Information
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NPI Number | 1124509468
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Entity Type | Individual
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Provider Name | DR. HADJIR HAGHPARAST HASSAS
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Gender | Male
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Dates
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Enumeration Date | 08/24/2018
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Last Update Date | 08/24/2018
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Provider Practice Location Address
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Address Line | 5122 OLYMPIC DR NW SUITE B101
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City | GIG HARBOR
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State | WA
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Zip | 98335
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Country | US
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Telephone | 253-851-5544
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Fax |
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Provider Business Mailing Address
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Address Line | 8 ROSEAPPLE RD
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City | RANCHO PALOS VERDES
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State | CA
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Zip | 90275
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Country | US
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Telephone | 310-357-9343
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 60857316
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 60857316
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License Number State | WA
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