Provider Demographics
NPI:1215232103
Name:ALHASHIM, ABDULMOHSIN HASSAN (DDS, MSD)
Entity Type:Individual
Prefix:DR
First Name:ABDULMOHSIN
Middle Name:HASSAN
Last Name:ALHASHIM
Suffix:
Gender:M
Credentials:DDS, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2318 MALONE WAY
Mailing Address - Street 2:
Mailing Address - City:EVANS
Mailing Address - State:GA
Mailing Address - Zip Code:30809-5312
Mailing Address - Country:US
Mailing Address - Phone:706-288-9448
Mailing Address - Fax:
Practice Address - Street 1:6780 S FORT APACHE RD STE 130
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89148-5405
Practice Address - Country:US
Practice Address - Phone:725-235-9301
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-24
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADNF0004191223P0700X
MNS1361223P0700X
NVS5-58C1223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA2587921OtherUNITED CONCORDIA
GA2587921OtherUNITED CONCORDIA