Provider Demographics
NPI:1871961706
Name:HANEY, KARMEN (RDH, BSDH)
Entity type:Individual
Prefix:MS
First Name:KARMEN
Middle Name:
Last Name:HANEY
Suffix:
Gender:F
Credentials:RDH, BSDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 HAINES
Mailing Address - Street 2:
Mailing Address - City:LIBERTY
Mailing Address - State:MO
Mailing Address - Zip Code:64068-1006
Mailing Address - Country:US
Mailing Address - Phone:816-595-4314
Mailing Address - Fax:
Practice Address - Street 1:800 HAINES
Practice Address - Street 2:
Practice Address - City:LIBERTY
Practice Address - State:MO
Practice Address - Zip Code:64068-1006
Practice Address - Country:US
Practice Address - Phone:816-595-4314
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-09
Last Update Date:2015-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2012033398124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist