Provider Demographics
NPI:1720249956
Name:DHAR, SHASHI K (AUD,CCC-A/SLP)
Entity Type:Individual
Prefix:DR
First Name:SHASHI
Middle Name:K
Last Name:DHAR
Suffix:
Gender:M
Credentials:AUD,CCC-A/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1702 ROCK SPRINGS ROAD
Mailing Address - Street 2:C/O AUDIOLOGY CONSULTANTS
Mailing Address - City:SMYRNA
Mailing Address - State:TN
Mailing Address - Zip Code:37167-6174
Mailing Address - Country:US
Mailing Address - Phone:615-625-7777
Mailing Address - Fax:615-625-7700
Practice Address - Street 1:1702 ROCK SPRINGS ROAD
Practice Address - Street 2:C/O AUDIOLOGY CONSULTANTS
Practice Address - City:SMYRNA
Practice Address - State:TN
Practice Address - Zip Code:37167-3716
Practice Address - Country:US
Practice Address - Phone:615-625-7777
Practice Address - Fax:615-625-7700
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-20
Last Update Date:2020-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNSP0000002046235Z00000X
TNA0000001173231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1522150Medicaid