Provider Demographics
NPI:1588023584
Name:LODHI, HAFSA (DDS)
Entity Type:Individual
Prefix:
First Name:HAFSA
Middle Name:
Last Name:LODHI
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 1:1501 WIND RIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42104-1058
Mailing Address - Country:US
Mailing Address - Phone:248-884-3864
Mailing Address - Fax:
Practice Address - Street 1:1785 CAMPBELL LN STE 100
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42104-1091
Practice Address - Country:US
Practice Address - Phone:270-842-6700
Practice Address - Fax:270-842-6770
Is Sole Proprietor?:No
Enumeration Date:2016-02-18
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN10164122300000X
FLDN24055122300000X
KY10800122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY10800OtherKENTUCKY DENTAL LICENSE
FLDN24055OtherFLORIDA DENTAL LICENSE