Provider Demographics
NPI:1942651088
Name:ALJUKIC, HASKA (DMD, MSD)
Entity type:Individual
Prefix:DR
First Name:HASKA
Middle Name:
Last Name:ALJUKIC
Suffix:
Gender:F
Credentials:DMD, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9710 PARK PLAZA AVE UNIT 101
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40241-2292
Mailing Address - Country:US
Mailing Address - Phone:502-327-6380
Mailing Address - Fax:502-327-8650
Practice Address - Street 1:9710 PARK PLAZA AVE
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40241-2291
Practice Address - Country:US
Practice Address - Phone:502-327-6380
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-30
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY10861223P0221X
KY9808122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No122300000XDental ProvidersDentist