Provider Demographics
NPI:1326675588
Name:HACKNEY, ANNA ZITO
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:ZITO
Last Name:HACKNEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:
Other - Last Name:ZITO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:301 RANDOLPH ST
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:MD
Mailing Address - Zip Code:21629-1243
Mailing Address - Country:US
Mailing Address - Phone:410-479-4306
Mailing Address - Fax:410-479-1714
Practice Address - Street 1:503 MUIR ST STE A
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21613-1848
Practice Address - Country:US
Practice Address - Phone:410-228-9381
Practice Address - Fax:410-228-9384
Is Sole Proprietor?:No
Enumeration Date:2020-03-26
Last Update Date:2020-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD7179124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist