Provider Demographics
NPI:1740478379
Name:ATTIA, HANY (DDS)
Entity type:Individual
Prefix:DR
First Name:HANY
Middle Name:
Last Name:ATTIA
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 1:3867 AYERS WAY
Mailing Address - Street 2:
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94582-5677
Mailing Address - Country:US
Mailing Address - Phone:310-500-7807
Mailing Address - Fax:
Practice Address - Street 1:433 ESTUDILLO AVE #303
Practice Address - Street 2:
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94577-4915
Practice Address - Country:US
Practice Address - Phone:510-969-8286
Practice Address - Fax:510-878-2773
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-09
Last Update Date:2024-10-29
Deactivation Date:2024-09-24
Deactivation Code:
Reactivation Date:2024-10-11
Provider Licenses
StateLicense IDTaxonomies
CA563571223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery