Provider Demographics
NPI:1942992615
Name:HENLEY, HANNAH MCCALMAN (DMD)
Entity type:Individual
Prefix:MISS
First Name:HANNAH
Middle Name:MCCALMAN
Last Name:HENLEY
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:HANNAH
Other - Middle Name:SIMS
Other - Last Name:MCCALMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2173 HIGHLAND AVE S APT H1506
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35205-4063
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:402A COGSWELL AVE
Practice Address - Street 2:
Practice Address - City:PELL CITY
Practice Address - State:AL
Practice Address - Zip Code:35125-2446
Practice Address - Country:US
Practice Address - Phone:205-338-2970
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-22
Last Update Date:2024-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL390200000X390200000X
ALD.007326-C11223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program