F MOFTAKHAR DDS A PROFESSIONAL CORP (NPI# 1063631109) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063631109 |
| Entity Type | Organization |
| Organization Name | F MOFTAKHAR DDS A PROFESSIONAL CORP |
| Other Organization Name | BAY AREA DENTAL SPECIALTY GROUP |
| Practice Address |
3301 E 12th St Ste 163 Oakland CA 94601-2939 |
| Mailing Address |
1809 E Eckerman Ave West Covina CA 91791-1112 |
| Practice Telephone | 5105331123 |
| Practice Fax Number | 5104855109 |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2008-07-15 |
| Authorized Official Name | DR. FARSHAD MOFTAKHAR (OWNER CEO) |
| Authorized Official Telephone | 6262460150 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
Dental Providers | ||
| N | 1223P0300X |
Dentist Specialization: Periodontics |
Dental Providers | ||
| N | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
Dental Providers | ||
| N | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
Dental Providers | ||
| Y | 1223E0200X |
Dentist Specialization: Endodontics |
Dental Providers |
| Other Name | Type Code |
|---|---|
| Bay Area Dental Specialty Group | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447479555 | F Moftakhar Dds A Professional Corp | Dentist | 3301 E 12th St Ste 165, Oakland, CA 94601-2939 | 2007-04-25 |
| Street Address |
3301 E 12TH ST STE 163 |
| City | OAKLAND |
| State | CA |
| Zip Code | 94601-2939 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750988762 | Mohini Gadre | Student in an Organized Health Care Education/Training Program | Casa Del Sol, 1501 Fruitvale Ave, Oakland, CA 94601 | 2020-10-02 |
| 1730704289 | Francheska Baloy | Student in an Organized Health Care Education/Training Program | 13585 San Pablo, San Pablo, CA 94601 | 2020-06-10 |
| 1104476597 | Jonathan Ramos Santiago | Social Worker | 13585 San Pablo, 1st Floor, San Pablo, CA 94601 | 2019-09-17 |
| 1205329802 | Stefany Menjivar | Student in an Organized Health Care Education/Training Program | 3908 International Blvd, Oakland, CA 94601 | 2018-06-08 |
| 1710408430 | Martha Alicia Rea | Physician Assistant | 3301 E. 12th St, Suite 113, Oakland, CA 94601 | 2017-07-03 |
| 1922528744 | Jamie Erin Briskin | Social Worker | 3001 International Blvd., Oakland, CA 94601 | 2017-06-22 |
| 1194254706 | Emily Lohmeyer | Student in an Organized Health Care Education/Training Program | 1501 Fruitvale Avenue, Oakland, CA 94601 | 2017-06-07 |
| 1124551494 | Emily Chana Wolfe-roubatis | Midwife | 1450 Fruitvale Ave Fl 3, Oakland, CA 94601 | 2017-04-04 |
| 1417327776 | Ninfa M. Gutierrez | Counselor | 3124 International Blvd., Oakland, CA 94601 | 2015-09-30 |
| 1942600424 | Reliable Care Express, Inc. | Non-emergency Medical Transport (VAN) | 828 27th Ave, Oakland, CA 94601 | 2014-09-03 |
| Find all providers in zip 94601 | ||||
| Taxonomy Code | 1223E0200X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Endodontics |
| The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265648679 | Barry Lai Fong | Dentist | 447 29th St Ste 109, Oakland, CA 94609-3597 | 2007-05-15 |
| 1902947682 | Steven R. Hansen | Dentist | 1700 Broadway, 10th Fl., Oakland, CA 94612-2116 | 2007-02-08 |
| 1386726743 | Alexander Thomas Kim | Dentist | 485 34th St Ste 200, Oakland, CA 94609-2823 | 2006-10-19 |
| 1609961226 | Unes Nabipour | Dentist | 2930 Summit St., Oakland, CA 94609 | 2006-10-03 |
| 1881706836 | Arthur S Panella | Dentist | 2930 Summit St, Oakland, CA 94609-3405 | 2006-08-31 |
| 1285642355 | Phuong N Quang | Dentist | 2844 Summit Street, Suite 209, Bay Endodontics, Oakland, CA 94609 | 2006-08-04 |
| 1760468656 | Ali Allen Rezai | Dentist | 485 34th St, Suite 200, Oakland, CA 94609-2823 | 2005-12-21 |
| 1225409469 | Brent C. Lin, Dds Inc | Dentist | 3040 E 9th St, Suite D, Oakland, CA 94601-2938 | 2015-10-14 |
| 1013308170 | Endo Care | Dentist | 485 34th St, Suite 200, Oakland, CA 94609-2823 | 2015-02-11 |
| 1902067747 | Midori Betty Tachibana | Dentist | 1624 Franklin St, Suite 1220, Oakland, CA 94612-2897 | 2008-06-24 |
| Find all providers in OAKLAND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.