Provider Demographics
NPI:1295027480
Name:SHINWARI, HASNAIN MOHAMMAD
Entity Type:Individual
Prefix:
First Name:HASNAIN
Middle Name:MOHAMMAD
Last Name:SHINWARI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 CHATHAM HEIGHTS RD
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22405-2566
Mailing Address - Country:US
Mailing Address - Phone:857-247-6414
Mailing Address - Fax:
Practice Address - Street 1:10 CHATHAM HEIGHTS RD
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22405-2566
Practice Address - Country:US
Practice Address - Phone:540-785-2216
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-06
Last Update Date:2016-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014150661223S0112X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program