Provider Demographics
NPI:1275150609
Name:HABIL, SOONDIS MANSUR (DMD)
Entity Type:Individual
Prefix:DR
First Name:SOONDIS
Middle Name:MANSUR
Last Name:HABIL
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13038 E COLORADO AVE
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80012-5322
Mailing Address - Country:US
Mailing Address - Phone:720-278-9790
Mailing Address - Fax:
Practice Address - Street 1:8441 W BOWLES AVE STE 220
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80123-9501
Practice Address - Country:US
Practice Address - Phone:303-979-2544
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-01
Last Update Date:2021-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN.002044761223G0001X
COT-DEN.000000551223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice