Provider Demographics
NPI:1134782733
Name:NADDER M HASSAN DDS
Entity type:Organization
Organization Name:NADDER M HASSAN DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:NADDER
Authorized Official - Middle Name:
Authorized Official - Last Name:HASSAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:703-335-1020
Mailing Address - Street 1:11490 COMMERCE PARK DR STE 110
Mailing Address - Street 2:
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20191-1532
Mailing Address - Country:US
Mailing Address - Phone:804-912-6733
Mailing Address - Fax:
Practice Address - Street 1:11490 COMMERCE PARK DR STE 110
Practice Address - Street 2:
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20191-1532
Practice Address - Country:US
Practice Address - Phone:804-912-6733
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-18
Last Update Date:2019-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty