Provider Demographics
NPI:1093493702
Name:SHAWI, MOHAMED BASEL (DMD)
Entity Type:Individual
Prefix:DR
First Name:MOHAMED
Middle Name:BASEL
Last Name:SHAWI
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1098 CORBRIDGE CT
Mailing Address - Street 2:
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-1812
Mailing Address - Country:US
Mailing Address - Phone:609-418-9135
Mailing Address - Fax:
Practice Address - Street 1:1001 LAUREL OAK RD STE C1
Practice Address - Street 2:
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-3512
Practice Address - Country:US
Practice Address - Phone:856-324-3361
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-11
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI02981901122300000X
NJ22DI02981900122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist