Healthcare Provider Details

I. General information

NPI: 1366608044
Provider Name (Legal Business Name): HASSAN CHIHAB DDS, MS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2008
Last Update Date: 08/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4301 FACTORIA BLVD SE SUITE B
BELLEVUE WA
98006-1982
US

IV. Provider business mailing address

4955 HIGHLAND DR
BELLEVUE WA
98006-3400
US

V. Phone/Fax

Practice location:
  • Phone: 425-747-8788
  • Fax: 425-747-3564
Mailing address:
  • Phone: 425-747-8788
  • Fax: 425-747-3564

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License NumberDE00008366
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: