1316476419 NPI number — HANY ATTIA, DDS, P.C.

Table of content: (NPI 1316476419)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1316476419 NPI number — HANY ATTIA, DDS, P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HANY ATTIA, DDS, P.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1316476419
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/30/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3867 AYERS WAY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN RAMON
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94582-5677
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
310-500-7807
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
433 ESTUDILLO AVE STE 303
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN LEANDRO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94577-4915
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
510-969-8286
Provider Business Practice Location Address Fax Number:
510-878-2773
Provider Enumeration Date:
06/12/2017

Additional Information

Authorized Official

Authorized Official Last Name:
ATTIA
Authorized Official First Name:
HANY
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
510-969-8286

Provider Taxonomy Codes

  • Taxonomy code: 1223S0112X , with the licence number:  56357 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1740478379 . This is a "NPI" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




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