Provider Demographics
NPI:1174658363
Name:HANNAWI, HIKMAT GABRIEL (DMD)
Entity Type:Individual
Prefix:DR
First Name:HIKMAT
Middle Name:GABRIEL
Last Name:HANNAWI
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 N MAIN ST
Mailing Address - Street 2:SUITE # 1
Mailing Address - City:ATTLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02703-1735
Mailing Address - Country:US
Mailing Address - Phone:508-222-2510
Mailing Address - Fax:508-222-3903
Practice Address - Street 1:550 N MAIN ST
Practice Address - Street 2:SUITE #1
Practice Address - City:ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02703-1735
Practice Address - Country:US
Practice Address - Phone:508-222-2510
Practice Address - Fax:508-222-3903
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2009-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA197631223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MADELTA DENTAL OF MASSOther19763
MANUICAREOther19763
MABCBS OF MASSOtherHAX 11292
MABCBS PPOOtherV05219
MAGUARDIANOther043539003
MA0299961Medicaid
MAALTUS DENTALOther19763
MACIGNA PPOOther19763
MAMETLIFEOther19763
MAAETNA PPOOther043539003
MABCBS OF RIOtherMOOOX11292
MADHAOther89461