Provider Demographics
NPI:1164123386
Name:MIKHAIL, HANY
Entity Type:Individual
Prefix:DR
First Name:HANY
Middle Name:
Last Name:MIKHAIL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 ASPEN WAY
Mailing Address - Street 2:
Mailing Address - City:HOPKINTON
Mailing Address - State:MA
Mailing Address - Zip Code:01748-1341
Mailing Address - Country:US
Mailing Address - Phone:313-652-6318
Mailing Address - Fax:
Practice Address - Street 1:18 DOWLING VILLAGE BLVD
Practice Address - Street 2:
Practice Address - City:NORTH SMITHFIELD
Practice Address - State:RI
Practice Address - Zip Code:02896-8267
Practice Address - Country:US
Practice Address - Phone:313-652-6318
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-14
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
RIDEN03659122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program