Healthcare Provider Details

I. General information

NPI: 1235747825
Provider Name (Legal Business Name): HANAH KHALED HASSOUNEH DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2020
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27490 RANCH ROAD 12 STE 108
DRIPPING SPRINGS TX
78620-4993
US

IV. Provider business mailing address

191 TABAGO CT
AUSTIN TX
78737-9354
US

V. Phone/Fax

Practice location:
  • Phone: 512-858-9250
  • Fax:
Mailing address:
  • Phone: 316-670-4150
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number61645
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number2022014893
License Number StateMO
# 3
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number42340
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: