Individual provider Active NPI

Haidy Hanna, DDS

  • Dentist
  • Tampa, FL
National Provider Identifier
1396267548
Registry record updated Jul 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
22540 Issued in FL
Practice address
7002 Gunn Hwy Ste 3
Tampa, FL 33625-3101
Phone
(813) 448-2239
NPI assigned
Jul 10, 2017
Last updated
Jul 10, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 22540 FL Primary

Addresses

Primary practice location

7002 Gunn Hwy Ste 3
Tampa, FL 33625-3101

Mailing address

1694 Feather Grass Loop
Lutz, FL 33558-2804

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170921001573 FL Order and Referring Only - DentistPractitioner - DentistPractitioner - Other (Physician) 5496029944

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22540FLMDDentist

Networks

  • Freedom Health HMO Network

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1499644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1499644800000",
    "number": "1396267548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1694 FEATHER GRASS LOOP",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335582804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7002 GUNN HWY STE 3",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336253101",
            "telephone_number": "813-448-2239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANNA",
        "first_name": "HAIDY",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-10",
        "last_updated": "2017-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "22540",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.