Provider Demographics
NPI:1386648707
Name:HINSHAW, DOUGLAS EARL (BS DDS)
Entity Type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:EARL
Last Name:HINSHAW
Suffix:
Gender:M
Credentials:BS DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:239 N BROADWAY AVE
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:KS
Mailing Address - Zip Code:67579-1916
Mailing Address - Country:US
Mailing Address - Phone:620-278-2150
Mailing Address - Fax:
Practice Address - Street 1:239 N BROADWAY AVE
Practice Address - Street 2:
Practice Address - City:STERLING
Practice Address - State:KS
Practice Address - Zip Code:67579-1916
Practice Address - Country:US
Practice Address - Phone:620-278-2150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-13
Last Update Date:2010-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS58881223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice