Provider Demographics
NPI:1578605986
Name:HANNA, NANCY (DMD)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:
Last Name:HANNA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2766 JOHN F KENNEDY BLVD
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07306-5508
Mailing Address - Country:US
Mailing Address - Phone:201-433-0773
Mailing Address - Fax:201-714-7056
Practice Address - Street 1:2766 JOHN F KENNEDY BLVD
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07306-5508
Practice Address - Country:US
Practice Address - Phone:201-433-0773
Practice Address - Fax:201-714-7056
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2013-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ18874122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist