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General NPI Number Information
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NPI Number | 1497064992
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Entity Type | Individual
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Provider Name | HANI MOHSENZADEH DDS, RDH
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Gender | Male
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Dates
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Enumeration Date | 09/30/2010
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Last Update Date | 07/30/2025
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Provider Practice Location Address
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Address Line | 144 STONY POINT RD
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City | SANTA ROSA
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State | CA
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Zip | 95401-4122
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Country | US
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Telephone | 707-521-4500
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Fax |
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Provider Business Mailing Address
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Address Line | 41 ROYAL GORGE ST
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City | SANTA ROSA
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State | CA
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Zip | 95409-4281
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Country | US
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Telephone | 619-274-5796
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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 | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | 24498
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 107197
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License Number State | CA
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