Provider Demographics
NPI:1609629724
Name:MAHFUJUL HASAN DDS,LLC
Entity Type:Organization
Organization Name:MAHFUJUL HASAN DDS,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MAHFUJUL
Authorized Official - Middle Name:
Authorized Official - Last Name:HASAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:917-834-8120
Mailing Address - Street 1:4014 GREENPOINT AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:LONG ISLAND CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11104-3619
Mailing Address - Country:US
Mailing Address - Phone:917-834-8120
Mailing Address - Fax:
Practice Address - Street 1:4014 GREENPOINT AVE APT 1
Practice Address - Street 2:
Practice Address - City:LONG ISLAND CITY
Practice Address - State:NY
Practice Address - Zip Code:11104-3619
Practice Address - Country:US
Practice Address - Phone:917-834-8120
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-09
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental