Provider Demographics
NPI:1457342891
Name:HANGALAY, MAHASIN M (DDS)
Entity Type:Individual
Prefix:
First Name:MAHASIN
Middle Name:M
Last Name:HANGALAY
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 1:822 EAST UNION HILLS DRIVE
Mailing Address - Street 2:SUITE D6
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85024
Mailing Address - Country:US
Mailing Address - Phone:623-582-6789
Mailing Address - Fax:623-780-3344
Practice Address - Street 1:822 EAST UNION HILLS DRIVE
Practice Address - Street 2:SUITE D6
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85024
Practice Address - Country:US
Practice Address - Phone:623-582-6789
Practice Address - Fax:623-780-3344
Is Sole Proprietor?:No
Enumeration Date:2005-11-03
Last Update Date:2007-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCDEN10003791223G0001X
MD135331223G0001X
AZD67471223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice