M Hani M Hassan Abbara
Individual provider Active NPI Dentist · Arroyo Grande, CA
NPI 1619792645 · NPPES record last updated Nov 15, 2024
Key facts
- NPI
- 1619792645
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 109886 (CA)
- Practice address
- 1237 E Grand Ave # 102
Arroyo Grande, CA 93420-2419 - Phone
- (316) 768-0285
- NPI assigned
- Nov 15, 2024
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 109886 | CA | MD | Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 109886 | CA | Yes |
Addresses
Primary practice location
1237 E Grand Ave # 102
Arroyo Grande, CA 93420-2419
Mailing address
2905 N Fox Pointe Cir
Wichita, KS 67226-2164
Other providers in Arroyo Grande, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 15, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.