Provider Demographics
NPI:1780877043
Name:HANOSH, ELIAS
Entity type:Individual
Prefix:DR
First Name:ELIAS
Middle Name:
Last Name:HANOSH
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 ARCHDALE DR APT 1206
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37064-1773
Mailing Address - Country:US
Mailing Address - Phone:505-314-6033
Mailing Address - Fax:505-224-2704
Practice Address - Street 1:1000 ARCHDALE DR APT 1206
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37064-1773
Practice Address - Country:US
Practice Address - Phone:505-314-6033
Practice Address - Fax:505-224-2704
Is Sole Proprietor?:No
Enumeration Date:2007-08-21
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN10737122300000X
NMDD2923122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist