Provider Demographics
NPI:1609551399
Name:HASANI, JAFER SADIQ (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAFER
Middle Name:SADIQ
Last Name:HASANI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 PEACOCK PL
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07731-2013
Mailing Address - Country:US
Mailing Address - Phone:848-299-9045
Mailing Address - Fax:
Practice Address - Street 1:301 FELLOWSHIP RD
Practice Address - Street 2:
Practice Address - City:MOUNT LAUREL
Practice Address - State:NJ
Practice Address - Zip Code:08054-1214
Practice Address - Country:US
Practice Address - Phone:856-222-1100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-20
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI029769001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice