Provider Demographics
NPI:1871953455
Name:HANSEN, HARLEEN (DMD)
Entity type:Individual
Prefix:DR
First Name:HARLEEN
Middle Name:
Last Name:HANSEN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:HARLEEN
Other - Middle Name:
Other - Last Name:AHUJA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:6235 E CHARTER OAK RD
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254
Mailing Address - Country:US
Mailing Address - Phone:602-390-1109
Mailing Address - Fax:
Practice Address - Street 1:9915 W MCDOWELL RD STE 106
Practice Address - Street 2:
Practice Address - City:AVONDALE
Practice Address - State:AZ
Practice Address - Zip Code:85392
Practice Address - Country:US
Practice Address - Phone:623-907-4562
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-25
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD009667122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty