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General NPI Number Information
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NPI Number | 1174688295
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Entity Type | Organization
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Legal Business Name | HAMED JAVADI D.D.S., M.S., INC.
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Dates
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Enumeration Date | 12/27/2006
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Last Update Date | 06/19/2023
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Provider Practice Location Address
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Address Line | 1615 HILL RD STE 4
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City | NOVATO
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State | CA
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Zip | 94947-4304
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Country | US
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Telephone | 415-898-6660
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Fax |
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Provider Business Mailing Address
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Address Line | 450 SUTTER ST RM 2018
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City | SAN FRANCISCO
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State | CA
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Zip | 94108-4104
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Country | US
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Telephone | 415-392-1265
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Fax | 415-392-1267
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. HAMED JAVADI
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Credential | D.D.S., M.S.
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Telephone | 415-392-1265
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 50413
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License Number State | CA
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