Provider Demographics
NPI:1861746851
Name:SADI, HANA (DMD,MSC)
Entity type:Individual
Prefix:
First Name:HANA
Middle Name:
Last Name:SADI
Suffix:
Gender:F
Credentials:DMD,MSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 KNEELAND STREET
Mailing Address - Street 2:ROOM 350
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02111
Mailing Address - Country:US
Mailing Address - Phone:617-636-6669
Mailing Address - Fax:617-636-3888
Practice Address - Street 1:1 KNEELAND ST
Practice Address - Street 2:ROOM 350
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02111-1527
Practice Address - Country:US
Practice Address - Phone:617-636-6669
Practice Address - Fax:617-636-3888
Is Sole Proprietor?:No
Enumeration Date:2012-10-30
Last Update Date:2012-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1856033122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist