Provider Demographics
NPI:1447481262
Name:HASHEM, MOHANNAD (DDS)
Entity type:Individual
Prefix:DR
First Name:MOHANNAD
Middle Name:
Last Name:HASHEM
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5105 ELDORADO PKWY
Mailing Address - Street 2:SUITE 150
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-8674
Mailing Address - Country:US
Mailing Address - Phone:214-387-0745
Mailing Address - Fax:
Practice Address - Street 1:5105 ELDORADO PKWY
Practice Address - Street 2:SUITE 150
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-8674
Practice Address - Country:US
Practice Address - Phone:214-387-0745
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-28
Last Update Date:2009-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX248291223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice