Healthcare Provider Details

I. General information

NPI: 1598178576
Provider Name (Legal Business Name): LAILA HUBBI DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2014
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

713 PIERCE RD
CLIFTON PARK NY
12065
US

IV. Provider business mailing address

713 PIERCE RD
CLIFTON PARK NY
12065
US

V. Phone/Fax

Practice location:
  • Phone: 518-373-1181
  • Fax:
Mailing address:
  • Phone: 518-373-1181
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number058761
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: