A Miracle Smile by Dr. Dezham Dental Group

Organization Active NPI Dentist · Sacramento, CA

NPI 1770775447 · NPPES record last updated Aug 15, 2007

Key facts

NPI
1770775447
Entity type
Organization (NPI type 2)
Primary specialty
Dentist 122300000X
License
52801 (CA)
Legal business name
A MIRACLE SMILE BY DR. DEZHAM DENTAL GROUP
Practice address
2131 Capitol Ave
Suite 100
Sacramento, CA 95816-5755
Phone
(916) 441-3311
Fax
(916) 441-0630
NPI assigned
Aug 15, 2007
Organization subpart
No

Authorized official

Name
Dr. Hassan Dezham
Title
Owner
Phone
(916) 441-3311

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Locations

2131 Capitol Ave
Ste 100
Sacramento, CA 95816
Phone (916) 441-3311

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist
Group: 193400000X SINGLE SPECIALTY GROUP
122300000X 52801 CA Yes

Addresses

Primary practice location

2131 Capitol Ave
Suite 100
Sacramento, CA 95816-5755

Mailing address

2131 Capitol Ave Ste 100
Sacramento, CA 95816-5755
Phone (916) 441-3311

Other providers in Sacramento, CA

All providers in Sacramento, CA · Dentist in California

Sources for this page

Verify at the official NPI Registry.