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General NPI Number Information
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NPI Number | 1609479567
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Entity Type | Individual
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Provider Name | SIAMAK SAHAND DMD
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Gender | Male
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Dates
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Enumeration Date | 11/20/2020
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Last Update Date | 08/01/2025
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Provider Practice Location Address
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Address Line | 14440 OLYMPIC DRIVE
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City | CLEARLAKE
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State | CA
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Zip | 95422-8809
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Country | US
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Telephone | 707-263-8383
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Fax | 707-263-5019
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Provider Business Mailing Address
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Address Line | 7547 QUAKERTOWN AVE
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City | WINNETKA
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State | CA
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Zip | 91306-2925
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Country | US
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Telephone |
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 105775
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License Number State | CA
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