Provider Demographics
NPI:1699511527
Name:AWAN, HIBBA AMER (DMD)
Entity type:Individual
Prefix:
First Name:HIBBA
Middle Name:AMER
Last Name:AWAN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8308 LINDAHL ALY
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32827-7772
Mailing Address - Country:US
Mailing Address - Phone:407-683-7223
Mailing Address - Fax:
Practice Address - Street 1:12711 NARCOOSSEE RD STE 100
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32832-6991
Practice Address - Country:US
Practice Address - Phone:407-627-1235
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-01
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN29271122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist