Siamak Okhovat, DDS, Inc

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

47541 Issued in CA

Legal business name

SIAMAK OKHOVAT, DDS, INC

Practice address

3984 Douglas Blvd
Suite 170
Roseville, CA 95661-4245

Phone

(916) 783-2333

Fax

(916) 783-2316

NPI assigned

May 29, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Linda J. Alexon

Title

Practice Administrator

Phone

(916) 783-2333

Specialties & licenses 1

Addresses

Other names 1

• Renaissance Dental Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1180396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1194926212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3984 DOUGLAS BLVD",
            "address_2": "SUITE 170",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956614245",
            "telephone_number": "916-783-2333",
            "fax_number": "916-783-2316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3984 DOUGLAS BLVD",
            "address_2": "SUITE 170",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956614245",
            "telephone_number": "916-783-2333",
            "fax_number": "916-783-2316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIAMAK OKHOVAT, DDS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ALEXON",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "916-783-2333"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "47541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Renaissance Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Doris Shurden-Lopez, LMFT
• Kateryna Shust
• Solomiia Shylova
• Dayana Shymchuk
• Micah Shyu
• Jocelyn Aquino Siapno, MS PSYCHOLOGY
• Javeed Siddiqui, MD, MPH
• Deepinder Sidhu, MD
• Hardeep K Sidhu, DDS
• Jasleen Kaur Sidhu, RPH

• General Practice Dentistry in Roseville, CA
• Providers in Roseville, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.