Provider Demographics
NPI:1235747825
Name:HASSOUNEH, HANAH KHALED (DDS)
Entity Type:Individual
Prefix:DR
First Name:HANAH
Middle Name:KHALED
Last Name:HASSOUNEH
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3105 N RIDGE PORT ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67205-2507
Mailing Address - Country:US
Mailing Address - Phone:316-670-4150
Mailing Address - Fax:
Practice Address - Street 1:233 N HILLSIDE ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67214-4903
Practice Address - Country:US
Practice Address - Phone:316-440-6400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-20
Last Update Date:2020-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS61645122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist