Provider Demographics
NPI:1962160085
Name:BASHAR HINNAWI DMD INC
Entity type:Organization
Organization Name:BASHAR HINNAWI DMD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:BASHAR
Authorized Official - Middle Name:
Authorized Official - Last Name:HINNAWI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:862-684-1109
Mailing Address - Street 1:480 WARREN DR APT 204
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94131-1006
Mailing Address - Country:US
Mailing Address - Phone:862-684-1109
Mailing Address - Fax:
Practice Address - Street 1:5404 NAVE DR
Practice Address - Street 2:
Practice Address - City:NOVATO
Practice Address - State:CA
Practice Address - Zip Code:94949-6404
Practice Address - Country:US
Practice Address - Phone:862-684-1109
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-06
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental