Provider Demographics
NPI:1558652966
Name:HANNANVASH, NAJMEH (DDS, MSD)
Entity Type:Individual
Prefix:DR
First Name:NAJMEH
Middle Name:
Last Name:HANNANVASH
Suffix:
Gender:F
Credentials:DDS, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5550 CARMEL MOUNTAIN ROAD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92130-2063
Mailing Address - Country:US
Mailing Address - Phone:503-888-1024
Mailing Address - Fax:
Practice Address - Street 1:5550 CARMEL MOUNTAIN RD STE 200
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92130-4861
Practice Address - Country:US
Practice Address - Phone:619-630-4000
Practice Address - Fax:619-630-0241
Is Sole Proprietor?:No
Enumeration Date:2011-04-20
Last Update Date:2020-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA613241223P0221X, 1223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry