Provider Demographics
NPI:1700238821
Name:HAKEEM, AISHA (DMD)
Entity Type:Individual
Prefix:DR
First Name:AISHA
Middle Name:
Last Name:HAKEEM
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6611 FM 1464 RD STE D
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-8222
Mailing Address - Country:US
Mailing Address - Phone:346-368-0100
Mailing Address - Fax:
Practice Address - Street 1:6611 FM 1464 RD STE D
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77407-8222
Practice Address - Country:US
Practice Address - Phone:346-368-0100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-13
Last Update Date:2021-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901022029122300000X
TX335451223G0001X
WADENT.DE.60972831223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist