Provider Demographics
NPI:1578207452
Name:HINA SHAH, DDS PC
Entity Type:Organization
Organization Name:HINA SHAH, DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:HINA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:517-381-9941
Mailing Address - Street 1:3955 OKEMOS RD STE B3
Mailing Address - Street 2:
Mailing Address - City:OKEMOS
Mailing Address - State:MI
Mailing Address - Zip Code:48864-3797
Mailing Address - Country:US
Mailing Address - Phone:517-381-9941
Mailing Address - Fax:
Practice Address - Street 1:3955 OKEMOS RD STE B3
Practice Address - Street 2:
Practice Address - City:OKEMOS
Practice Address - State:MI
Practice Address - Zip Code:48864-3797
Practice Address - Country:US
Practice Address - Phone:517-381-9941
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-26
Last Update Date:2022-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty