Provider Demographics
NPI:1538375316
Name:MICHAEL, HANK DANIEL (DMD)
Entity type:Individual
Prefix:DR
First Name:HANK
Middle Name:DANIEL
Last Name:MICHAEL
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5757 S TAMIAMI TRL
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34231-4136
Mailing Address - Country:US
Mailing Address - Phone:941-929-7645
Mailing Address - Fax:941-921-6909
Practice Address - Street 1:5757 S TAMIAMI TRL
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34231-4136
Practice Address - Country:US
Practice Address - Phone:941-929-7645
Practice Address - Fax:941-921-6909
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2020-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN157081223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLDN15708OtherFLORIDA DENTAL LICENSE