Provider Demographics
NPI:1275092082
Name:THE DENTAL GROUP OF IHAB M HANNA DDS & KARRISHMA JUMANI DDS INC
Entity Type:Organization
Organization Name:THE DENTAL GROUP OF IHAB M HANNA DDS & KARRISHMA JUMANI DDS INC
Other - Org Name:BAY AREA IMPLANT CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:IHAB
Authorized Official - Middle Name:M
Authorized Official - Last Name:HANNA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:650-454-0023
Mailing Address - Street 1:20 BIRCH ST
Mailing Address - Street 2:
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94062-1409
Mailing Address - Country:US
Mailing Address - Phone:650-701-1111
Mailing Address - Fax:
Practice Address - Street 1:20 BIRCH ST
Practice Address - Street 2:
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94062-1409
Practice Address - Country:US
Practice Address - Phone:650-701-1111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-19
Last Update Date:2019-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No1223P0300XDental ProvidersDentistPeriodonticsGroup - Multi-Specialty
No1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Multi-Specialty
No1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty
No124Q00000XDental ProvidersDental HygienistGroup - Multi-Specialty
No126800000XDental ProvidersDental AssistantGroup - Multi-Specialty