Provider Demographics
NPI:1467936377
Name:ALSIBAI, HANI (BDS)
Entity Type:Individual
Prefix:
First Name:HANI
Middle Name:
Last Name:ALSIBAI
Suffix:
Gender:M
Credentials:BDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10020 BENNETT PL
Mailing Address - Street 2:
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55347-4406
Mailing Address - Country:US
Mailing Address - Phone:952-334-1975
Mailing Address - Fax:
Practice Address - Street 1:715 OLD AUSTIN HWY STE 400
Practice Address - Street 2:
Practice Address - City:BASTROP
Practice Address - State:TX
Practice Address - Zip Code:78602-5165
Practice Address - Country:US
Practice Address - Phone:512-212-9803
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-18
Last Update Date:2023-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX347181223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics