Provider Demographics
NPI:1811010697
Name:HANNA, SARAH H (DDS)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:H
Last Name:HANNA
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 1:520 SUMMIT AVENUE
Mailing Address - Street 2:
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601
Mailing Address - Country:US
Mailing Address - Phone:201-488-9030
Mailing Address - Fax:201-488-9130
Practice Address - Street 1:40 ROBERT PITT DR
Practice Address - Street 2:
Practice Address - City:MONSEY
Practice Address - State:NY
Practice Address - Zip Code:10952-3333
Practice Address - Country:US
Practice Address - Phone:845-352-6800
Practice Address - Fax:845-352-6800
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2011-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1953000122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6739105Medicaid