Provider Demographics
NPI:1780959411
Name:HASSAN, NADDER (DDS)
Entity type:Individual
Prefix:
First Name:NADDER
Middle Name:
Last Name:HASSAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9954 LIBERIA AVE
Mailing Address - Street 2:
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20110-7052
Mailing Address - Country:US
Mailing Address - Phone:703-335-1020
Mailing Address - Fax:703-335-2384
Practice Address - Street 1:9954 LIBERIA AVE
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20110-7052
Practice Address - Country:US
Practice Address - Phone:703-335-1020
Practice Address - Fax:703-335-2384
Is Sole Proprietor?:No
Enumeration Date:2012-03-13
Last Update Date:2015-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA401413855122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist