Individual provider Active NPI

Sepand Hokmabadi, D.D.S

  • General Practice Dentistry
  • Oakland, CA
National Provider Identifier
1689883563
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
50270 Issued in CA
Practice address
1880 Pleasant Valley Ave Ste F
Oakland, CA 94611-4211
Phone
(510) 654-5752
Fax
(510) 655-6374
NPI assigned
May 21, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 50270 CA Primary

Addresses

Primary practice location

1880 Pleasant Valley Ave Ste F
Oakland, CA 94611-4211

Mailing address

2195 Beach St Apt 104
San Francisco, CA 94123-1461
Phone (415) 830-1588

Other identifiers 1

IdentifierTypeStateIssuer
87-0766116OtherCATAX I.D. NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
50270CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689883563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2195 BEACH ST APT 104",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941231461",
            "telephone_number": "415-830-1588",
            "fax_number": "510-655-6374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1880 PLEASANT VALLEY AVE STE F",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946114211",
            "telephone_number": "510-654-5752",
            "fax_number": "510-655-6374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOKMABADI",
        "first_name": "SEPAND",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "50270",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX I.D. NUMBER",
            "identifier": "87-0766116",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.