Provider Demographics
NPI:1225816788
Name:AFFENDI, HAFSA (BDS, MDS, MS)
Entity Type:Individual
Prefix:DR
First Name:HAFSA
Middle Name:
Last Name:AFFENDI
Suffix:
Gender:F
Credentials:BDS, MDS, MS
Other - Prefix:DR
Other - First Name:HAFSA
Other - Middle Name:
Other - Last Name:EFFENDI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BDS
Mailing Address - Street 1:3077 SIGNATURE BLVD APT B
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-6495
Mailing Address - Country:US
Mailing Address - Phone:862-298-1877
Mailing Address - Fax:
Practice Address - Street 1:315 E EISENHOWER PKWY STE 220
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48108-3330
Practice Address - Country:US
Practice Address - Phone:734-761-3166
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-18
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI232560409011223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty