Provider Demographics
NPI:1255457610
Name:HANACHI, FARID (DDS PA)
Entity type:Individual
Prefix:DR
First Name:FARID
Middle Name:
Last Name:HANACHI
Suffix:
Gender:
Credentials:DDS PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:367 WILLIAMSON RD STE 101
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28117-5945
Mailing Address - Country:US
Mailing Address - Phone:704-662-0203
Mailing Address - Fax:704-662-0355
Practice Address - Street 1:367 WILLIAMSON RD STE 101
Practice Address - Street 2:
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28117-5945
Practice Address - Country:US
Practice Address - Phone:704-662-0203
Practice Address - Fax:704-662-0355
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC61161223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics