Provider Demographics
NPI:1851925259
Name:FOX, HANNAH KRISTINA (DDS)
Entity Type:Individual
Prefix:DR
First Name:HANNAH
Middle Name:KRISTINA
Last Name:FOX
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 1:9447 DANTLEY CT
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95624-6022
Mailing Address - Country:US
Mailing Address - Phone:916-544-2251
Mailing Address - Fax:
Practice Address - Street 1:5401 ARNOLD AVE # 88
Practice Address - Street 2:
Practice Address - City:MCCLELLAN
Practice Address - State:CA
Practice Address - Zip Code:95652-1018
Practice Address - Country:US
Practice Address - Phone:916-544-2251
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-25
Last Update Date:2020-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1048051223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice