Provider Demographics
NPI:1447331715
Name:SADEK, HANI (DDS)
Entity type:Individual
Prefix:
First Name:HANI
Middle Name:
Last Name:SADEK
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:779 HARRISBURG PIKE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43223-2113
Mailing Address - Country:US
Mailing Address - Phone:614-276-6226
Mailing Address - Fax:614-276-6129
Practice Address - Street 1:779 HARRISBURG PIKE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43223-2113
Practice Address - Country:US
Practice Address - Phone:614-276-6226
Practice Address - Fax:614-276-6129
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH21621122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2368772Medicaid