Basic Information
| Provider Information | |||||||||
| NPI: | 1811010697 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HANNA | ||||||||
| FirstName: | SARAH | ||||||||
| MiddleName: | H | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | DDS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 520 SUMMIT AVENUE | ||||||||
| Address2: | |||||||||
| City: | HACKENSACK | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 07601 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2014889030 | ||||||||
| FaxNumber: | 2014889130 | ||||||||
| Practice Location | |||||||||
| Address1: | 40 ROBERT PITT DR | ||||||||
| Address2: | |||||||||
| City: | MONSEY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 109523333 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8453526800 | ||||||||
| FaxNumber: | 8453526800 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/09/2007 | ||||||||
| LastUpdateDate: | 02/14/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 122300000X | 1953000 | NJ | Y | Dental Providers | Dentist |
ID Information
| ID | Type | State | Issuer | Description | 6739105 | 05 | NJ | MEDICAID |