Provider Demographics
NPI:1992966766
Name:JOHN W. MASHNI, D.D.S., P.C.
Entity type:Organization
Organization Name:JOHN W. MASHNI, D.D.S., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:WADIE
Authorized Official - Last Name:MASHNI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:517-351-1733
Mailing Address - Street 1:2121 ABBOT RD
Mailing Address - Street 2:
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48823-8535
Mailing Address - Country:US
Mailing Address - Phone:517-351-1733
Mailing Address - Fax:517-351-5709
Practice Address - Street 1:2121 ABBOT RD
Practice Address - Street 2:
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48823-8535
Practice Address - Country:US
Practice Address - Phone:517-351-1733
Practice Address - Fax:517-351-5709
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-24
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI110961223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty