Provider Demographics
NPI:1558713073
Name:HASSAN, ENGY (DDS)
Entity Type:Individual
Prefix:DR
First Name:ENGY
Middle Name:
Last Name:HASSAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 ELENA ST
Mailing Address - Street 2:
Mailing Address - City:CRANSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02920-4379
Mailing Address - Country:US
Mailing Address - Phone:917-300-0084
Mailing Address - Fax:
Practice Address - Street 1:4000 CHAPEL VIEW BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02920
Practice Address - Country:US
Practice Address - Phone:401-867-2585
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-08
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0409671223G0001X
RIDEN036141223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics
No1223G0001XDental ProvidersDentistGeneral Practice