Provider Demographics
NPI:1437360971
Name:DR HASSANI ANGAMUTHU & ASSOCIATES DDS PA
Entity Type:Organization
Organization Name:DR HASSANI ANGAMUTHU & ASSOCIATES DDS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:EFTEKHAR
Authorized Official - Middle Name:
Authorized Official - Last Name:HASSANI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:301-990-3697
Mailing Address - Street 1:4 PROFESSIONAL DRIVE
Mailing Address - Street 2:SUITE 121
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20879
Mailing Address - Country:US
Mailing Address - Phone:301-990-3697
Mailing Address - Fax:301-990-3697
Practice Address - Street 1:4 PROFESSIONAL DRIVE
Practice Address - Street 2:SUITE 121
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20879
Practice Address - Country:US
Practice Address - Phone:301-990-3697
Practice Address - Fax:301-990-3697
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty