Provider Demographics
NPI:1447232293
Name:KNABIMDITHASBANI, DAOUD (DDS)
Entity Type:Individual
Prefix:
First Name:DAOUD
Middle Name:
Last Name:KNABIMDITHASBANI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:DAVID
Other - Middle Name:
Other - Last Name:HASBANI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1311 KINGS HWY
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-1903
Mailing Address - Country:US
Mailing Address - Phone:718-339-7773
Mailing Address - Fax:718-339-7779
Practice Address - Street 1:1870 GRAND CONCOURSE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10457-5401
Practice Address - Country:US
Practice Address - Phone:718-731-6377
Practice Address - Fax:718-731-6773
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0479021122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY9369OtherDORAL
NYD00049101OtherAMERICHOICE
NY01913377Medicaid