Provider Demographics
NPI:1861945933
Name:HAFEEZ, UMME KALSOOM (DMD)
Entity type:Individual
Prefix:DR
First Name:UMME
Middle Name:KALSOOM
Last Name:HAFEEZ
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:309 FLORENCE AVE APT 119N
Mailing Address - Street 2:
Mailing Address - City:JENKINTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19046-2604
Mailing Address - Country:US
Mailing Address - Phone:609-357-8166
Mailing Address - Fax:
Practice Address - Street 1:309 FLORENCE AVE APT 119N
Practice Address - Street 2:
Practice Address - City:JENKINTOWN
Practice Address - State:PA
Practice Address - Zip Code:19046-2604
Practice Address - Country:US
Practice Address - Phone:609-357-8166
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-25
Last Update Date:2016-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0409701223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice