Healthcare Provider Details

I. General information

NPI: 1932946738
Provider Name (Legal Business Name): EMAN HAWASS DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/10/2024
Last Update Date: 07/10/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3876 S HIGHWAY 27 BRUMMETT FAMILY DENTAL
SOMERSET KY
42501
US

IV. Provider business mailing address

2429 GLEN EAGLE DR
LOUISVILLE KY
40222
US

V. Phone/Fax

Practice location:
  • Phone: 606-679-5328
  • Fax:
Mailing address:
  • Phone: 502-554-2400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number11193
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number11193
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: