Shadan Hafsa

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN 21493 Issued in FL

Practice address

611 E Bloomingdale Ave Ste C
Brandon, FL 33511-8127

Phone

(813) 820-0071

Fax

(813) 820-0072

NPI assigned

Jul 26, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• Freedom Health HMO Network

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Dental Day LLC

  • General Practice Dentistry
  • Brandon, FL
  • NPI 1295206324
  NPD Authorized official

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

{
    "created_epoch": "1437868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603929600000",
    "number": "1699150110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 E BLOOMINGDALE AVE STE C",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335118127",
            "telephone_number": "813-820-0071",
            "fax_number": "813-820-0072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 E BLOOMINGDALE AVE STE C",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335118127",
            "telephone_number": "813-820-0071",
            "fax_number": "813-820-0072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAFSA",
        "first_name": "SHADAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-26",
        "last_updated": "2020-10-29",
        "certification_date": "2020-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN 21493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edgardo J Guzman Rivera, MD
• Olivia Gwaltney
• H-Bay Ministries, Inc. (Superior Residences of Brandon Memory Care)
• My My Ha, MA, BCBA
• Nancy Hadsock, M.S., C.C.C.
• Larry David Hagaman, PA-C
• Mathew Adam Hagen
• Jessica Hager
• Jennifer Haglund, COTA
• Nafeeza Hakeem-Hosein

• General Practice Dentistry in Brandon, FL
• Providers in Brandon, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.