Provider Demographics
NPI:1790529394
Name:HABIB, HAFIZA SANA (DDS)
Entity type:Individual
Prefix:
First Name:HAFIZA SANA
Middle Name:
Last Name:HABIB
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 1:5209 WHEAT RIDGE PL
Mailing Address - Street 2:
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23059-5651
Mailing Address - Country:US
Mailing Address - Phone:804-790-9070
Mailing Address - Fax:
Practice Address - Street 1:7522 LEE DAVIS RD
Practice Address - Street 2:
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23111-3603
Practice Address - Country:US
Practice Address - Phone:804-559-1016
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-20
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014189421223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice