NPIMap

Organization Active NPI

Lodi Dental Group

  • Dentist
  • Lodi, CA
National Provider Identifier
1740470178
Registry record updated Aug 1, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
39643 Issued in CA
Legal business name
LODI DENTAL GROUP
Practice address
531 Kettleman LN
Lodi, CA 95240
Phone
(209) 366-1850
Fax
(209) 333-1879
NPI assigned
Aug 1, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2007

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

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 39643 CA Primary

Addresses

Primary practice location

531 Kettleman LN
Lodi, CA 95240

Mailing address

PO Box 55368
Valencia, CA 91385-0368
Phone (661) 255-3130

National Provider Directory

National Provider Directory
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.

NPI Registry JSON

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": "1740470178",
    "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": "531 KETTLEMAN LN",
            "city": "LODI",
            "state": "CA",
            "postal_code": "95240",
            "telephone_number": "209-366-1850",
            "fax_number": "209-333-1879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LODI DENTAL GROUP",
        "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": []
}

Other providers in Lodi, CA

Sources for this page

  • 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.