Provider Demographics
NPI:1215235924
Name:HANNA, NABIL S (DDS)
Entity type:Individual
Prefix:MR
First Name:NABIL
Middle Name:S
Last Name:HANNA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:MR
Other - First Name:NABIL
Other - Middle Name:H
Other - Last Name:SAAD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:400 W AIRPORT BLVD
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32773-5489
Mailing Address - Country:US
Mailing Address - Phone:407-665-3345
Mailing Address - Fax:407-665-3034
Practice Address - Street 1:400 W AIRPORT BLVD
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:FL
Practice Address - Zip Code:32773-5489
Practice Address - Country:US
Practice Address - Phone:407-665-3200
Practice Address - Fax:407-665-3213
Is Sole Proprietor?:No
Enumeration Date:2011-03-03
Last Update Date:2016-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN8976122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL077170800Medicaid