Healthcare Provider Details

I. General information

NPI: 1508314816
Provider Name (Legal Business Name): AMNA HASAN BDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/15/2016
Last Update Date: 02/25/2026
Certification Date: 02/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

770 QUBEIN AVE
HIGH POINT NC
27268-0001
US

IV. Provider business mailing address

770 QUBEIN AVE
HIGH POINT NC
27268-0001
US

V. Phone/Fax

Practice location:
  • Phone: 704-550-6203
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X2210X
TaxonomyOrofacial Pain Dentistry
License Number00176
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number00176
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: