Provider Demographics
NPI:1043074354
Name:SADI KERMANI DDS PC INC
Entity type:Organization
Organization Name:SADI KERMANI DDS PC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SADI
Authorized Official - Middle Name:
Authorized Official - Last Name:KERMANI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:415-336-7234
Mailing Address - Street 1:1331 MEDICAL CENTER DR STE F
Mailing Address - Street 2:
Mailing Address - City:ROHNERT PARK
Mailing Address - State:CA
Mailing Address - Zip Code:94928-2900
Mailing Address - Country:US
Mailing Address - Phone:707-852-1662
Mailing Address - Fax:707-755-3895
Practice Address - Street 1:1331 MEDICAL CENTER DR STE F
Practice Address - Street 2:
Practice Address - City:ROHNERT PARK
Practice Address - State:CA
Practice Address - Zip Code:94928-2900
Practice Address - Country:US
Practice Address - Phone:707-852-1662
Practice Address - Fax:707-755-3895
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-07
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty