Individual provider Active NPI

Hassnen Fakhrulddin

  • Dentist
  • Houston, TX
National Provider Identifier
1639879364
Registry record updated Nov 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
40117 Issued in TX
Practice address
6407 Hillcroft St
Houston, TX 77081-3101
Phone
(832) 778-7312
NPI assigned
Mar 9, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 40117 TX Primary

Addresses

Primary practice location

6407 Hillcroft St
Houston, TX 77081-3101

Mailing address

10510 W Aliana Trace Dr Apt 101
Richmond, TX 77407-1138
Phone (832) 778-7312

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
40117TXMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1678320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701302400000",
    "number": "1639879364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10510 W ALIANA TRACE DR APT 101",
            "city": "RICHMOND",
            "state": "TX",
            "postal_code": "774071138",
            "telephone_number": "832-778-7312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6407 HILLCROFT ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770813101",
            "telephone_number": "832-778-7312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAKHRULDDIN",
        "first_name": "HASSNEN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-09",
        "last_updated": "2023-11-30",
        "certification_date": "2023-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "40117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.