Petaluma Family Dental Care

Primary specialty

DentistTaxonomy code 122300000X

License

39643 Issued in CA

Legal business name

PETALUMA FAMILY DENTAL CARE

Practice address

35 Maria Dr
Ste 854
Petaluma, CA 94954-3548

Phone

(707) 763-3203

Fax

(707) 763-3121

NPI assigned

Aug 1, 2007

Organization subpart

No

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

Authorized official

Name

Sean Hakimi, D.D.S.

Title

Owner

Phone

(661) 255-3130

Specialties & licenses 1

Addresses

Tax ID family

Lodi Dental Group2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Lodi Dental Group

  • Dentist
  • Lodi, CA
  • NPI 1740470178
  NPD tax ID

Locations

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

{
    "created_epoch": "1185926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185926400000",
    "number": "1295925634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 55368",
            "city": "VALENCIA",
            "state": "CA",
            "postal_code": "913850368",
            "telephone_number": "661-255-3130",
            "fax_number": "661-451-5248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 MARIA DR",
            "address_2": "STE 854",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949543548",
            "telephone_number": "707-763-3203",
            "fax_number": "707-763-3121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETALUMA FAMILY DENTAL CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-01",
        "last_updated": "2007-08-01",
        "status": "A",
        "authorized_official_last_name": "HAKIMI",
        "authorized_official_first_name": "SEAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "661-255-3130",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "39643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Petaluma C.C. Inc.
• Petaluma City Schools
• Petaluma Emergency Physicians Medical Corporation
• Petaluma Eye Care Optometric Associates, Inc.
• Petaluma Eye Care Optometric Associates, Inc. a Professional Corp.
• Petaluma Family Therapy Inc
• Petaluma Health Center Inc
• Petaluma Health Center, Inc
• Petaluma Health Center, Inc
• Petaluma Health Center, Inc

• Dentist in Petaluma, CA
• Providers in Petaluma, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2007; 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.