Provider Demographics
NPI:1386894715
Name:HASAN-VERRETT, HAJAR FATIHAH (DDS)
Entity type:Individual
Prefix:DR
First Name:HAJAR
Middle Name:FATIHAH
Last Name:HASAN-VERRETT
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:HAJAR
Other - Middle Name:FATIHAH
Other - Last Name:HASAN-VERRETT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:2056 NE 167TH ST APT 1
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33162-6217
Mailing Address - Country:US
Mailing Address - Phone:305-812-6321
Mailing Address - Fax:
Practice Address - Street 1:3058 NW 79TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33147-4706
Practice Address - Country:US
Practice Address - Phone:305-696-9999
Practice Address - Fax:305-696-2050
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-22
Last Update Date:2011-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN184791223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice