Provider Demographics
NPI:1285228361
Name:SHAHINIAN, CASSANDRA (DMD)
Entity Type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:
Last Name:SHAHINIAN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:277 CREST PL
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN LAKES
Mailing Address - State:NJ
Mailing Address - Zip Code:07417-2705
Mailing Address - Country:US
Mailing Address - Phone:781-267-0929
Mailing Address - Fax:
Practice Address - Street 1:946 MAIN ST
Practice Address - Street 2:
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-5136
Practice Address - Country:US
Practice Address - Phone:201-464-4783
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-01
Last Update Date:2021-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI028235001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice