Provider Demographics
NPI:1720650518
Name:SHEN, HANYI (DMD)
Entity Type:Individual
Prefix:
First Name:HANYI
Middle Name:
Last Name:SHEN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27237 172ND AVE SE STE 105A
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98042-7352
Mailing Address - Country:US
Mailing Address - Phone:253-263-7010
Mailing Address - Fax:
Practice Address - Street 1:27237 172ND AVE SE STE 105A
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:WA
Practice Address - Zip Code:98042-7352
Practice Address - Country:US
Practice Address - Phone:253-263-7010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-12
Last Update Date:2021-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADENT.DE.611838721223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice