Provider Demographics
NPI:1144344656
Name:HASSON, HANA K (DDS)
Entity type:Individual
Prefix:
First Name:HANA
Middle Name:K
Last Name:HASSON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1011 N UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48109-1078
Mailing Address - Country:US
Mailing Address - Phone:734-615-9513
Mailing Address - Fax:734-615-4784
Practice Address - Street 1:1011 N UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48109-1078
Practice Address - Country:US
Practice Address - Phone:734-615-9513
Practice Address - Fax:734-615-4784
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI290500038122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MID500038OtherBCBS OF MI DENTAL
MI195816309OtherBCBS OF MED SURGICAL
MI0N6540009Medicare PIN
MIV04953Medicare UPIN