Healthcare Provider Details

I. General information

NPI: 1255969556
Provider Name (Legal Business Name): LANA HASHIM DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/31/2020
Last Update Date: 07/28/2022
Certification Date: 07/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

466 MAIN ST
NEW ROCHELLE NY
10801-6431
US

IV. Provider business mailing address

1523 CENTRAL PARK AVE APT 14E
YONKERS NY
10710-6028
US

V. Phone/Fax

Practice location:
  • Phone: 914-633-5050
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number061850
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: