Provider Demographics
NPI:1053338087
Name:LAKHA, AZEEM K (DMD)
Entity type:Individual
Prefix:
First Name:AZEEM
Middle Name:K
Last Name:LAKHA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:SCOTT
Other - Middle Name:C
Other - Last Name:BAIRD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:720 COWPER ST
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94301-2602
Mailing Address - Country:US
Mailing Address - Phone:650-328-6622
Mailing Address - Fax:650-328-9970
Practice Address - Street 1:720 COWPER ST
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94301-2602
Practice Address - Country:US
Practice Address - Phone:650-328-6622
Practice Address - Fax:650-328-9970
Is Sole Proprietor?:No
Enumeration Date:2006-07-16
Last Update Date:2010-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA0341391223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery