Provider Demographics
NPI:1790398345
Name:HANEEF, SALMA (DDS)
Entity Type:Individual
Prefix:
First Name:SALMA
Middle Name:
Last Name:HANEEF
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 1:2020 HEMISON LN
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75056-3898
Mailing Address - Country:US
Mailing Address - Phone:972-900-2074
Mailing Address - Fax:
Practice Address - Street 1:3501 FM 407 E STE 200
Practice Address - Street 2:
Practice Address - City:LANTANA
Practice Address - State:TX
Practice Address - Zip Code:76226-9769
Practice Address - Country:US
Practice Address - Phone:940-489-1660
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-24
Last Update Date:2020-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX366281223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty