Healthcare Provider Details

I. General information

NPI: 1477039360
Provider Name (Legal Business Name): HINA EJAZ DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/14/2018
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

670 W LINCOLN HWY
EXTON PA
19341-2514
US

IV. Provider business mailing address

4723 HILTON RD
SCHNECKSVILLE PA
18078-2320
US

V. Phone/Fax

Practice location:
  • Phone: 610-873-4003
  • Fax:
Mailing address:
  • Phone: 484-892-1615
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License NumberG1-0011601
License Number StateDE
# 2
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDS041837
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: