Provider Demographics
NPI:1124736285
Name:HASOON, ALI (DMD)
Entity type:Individual
Prefix:DR
First Name:ALI
Middle Name:
Last Name:HASOON
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13542 RED FERN LN
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75240-5809
Mailing Address - Country:US
Mailing Address - Phone:469-585-6938
Mailing Address - Fax:
Practice Address - Street 1:13542 RED FERN LN
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75240-5809
Practice Address - Country:US
Practice Address - Phone:469-585-6938
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-08
Last Update Date:2022-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX39111122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist