Provider Demographics
NPI:1205924966
Name:HASSEN, HARLAN L (DDS)
Entity type:Individual
Prefix:
First Name:HARLAN
Middle Name:L
Last Name:HASSEN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 NE BARRY RD
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64155-2721
Mailing Address - Country:US
Mailing Address - Phone:816-454-6443
Mailing Address - Fax:816-454-3145
Practice Address - Street 1:209 NE BARRY RD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64155-2721
Practice Address - Country:US
Practice Address - Phone:816-454-6443
Practice Address - Fax:816-454-3145
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2017-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0134811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice