Provider Demographics
NPI:1417033341
Name:MASHNI, DAN
Entity Type:Individual
Prefix:DR
First Name:DAN
Middle Name:
Last Name:MASHNI
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 1:751 CHESTNUT ST STE 103
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:MI
Mailing Address - Zip Code:48009-6463
Mailing Address - Country:US
Mailing Address - Phone:248-647-1144
Mailing Address - Fax:
Practice Address - Street 1:751 CHESTNUT ST STE 103
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:MI
Practice Address - Zip Code:48009-6463
Practice Address - Country:US
Practice Address - Phone:248-647-1144
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2022-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901018210122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist