Provider Demographics
NPI:1669024295
Name:ABBAS, HASNAIN (DDS, BDS)
Entity Type:Individual
Prefix:
First Name:HASNAIN
Middle Name:
Last Name:ABBAS
Suffix:
Gender:M
Credentials:DDS, BDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3030 LBJ FWY STE 1400
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75234-2766
Mailing Address - Country:US
Mailing Address - Phone:972-663-5301
Mailing Address - Fax:972-663-5229
Practice Address - Street 1:1418 S BUCKNER BLVD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75217-1703
Practice Address - Country:US
Practice Address - Phone:972-663-5380
Practice Address - Fax:972-663-5280
Is Sole Proprietor?:No
Enumeration Date:2019-07-13
Last Update Date:2019-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TX355841223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program