Provider Demographics
NPI:1790174100
Name:WEINMAN, SHANA (DDS)
Entity Type:Individual
Prefix:DR
First Name:SHANA
Middle Name:
Last Name:WEINMAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:MRS
Other - First Name:SHANA
Other - Middle Name:
Other - Last Name:MASHAAL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:233 E SHORE RD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11023-2436
Mailing Address - Country:US
Mailing Address - Phone:516-482-5924
Mailing Address - Fax:888-311-9754
Practice Address - Street 1:233 E SHORE RD
Practice Address - Street 2:SUITE 110
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11023-2436
Practice Address - Country:US
Practice Address - Phone:516-482-5924
Practice Address - Fax:888-311-9754
Is Sole Proprietor?:No
Enumeration Date:2015-01-22
Last Update Date:2015-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0478771223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice