Provider Demographics
NPI:1538245519
Name:MAKKAWY, HANY M (DDS)
Entity type:Individual
Prefix:DR
First Name:HANY
Middle Name:M
Last Name:MAKKAWY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1900 DEVOE DR
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-1865
Mailing Address - Country:US
Mailing Address - Phone:402-472-1317
Mailing Address - Fax:402-472-5290
Practice Address - Street 1:40TH & HOLDREGE STREETS
Practice Address - Street 2:COLLEGE OF DENTISTRY
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68583-0740
Practice Address - Country:US
Practice Address - Phone:402-472-1317
Practice Address - Fax:402-472-5290
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2008-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE57261223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47078998500Medicaid
NE5890OtherBC/BS