Healthcare Provider Details

I. General information

NPI: 1437161320
Provider Name (Legal Business Name): VIRGINIA D SHAHINIAN DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 SOUTH STREET #201
HINGHAM MA
02043
US

IV. Provider business mailing address

430 ATLANTIC AVENUE
COHASSET MA
02025
US

V. Phone/Fax

Practice location:
  • Phone: 781-740-0100
  • Fax:
Mailing address:
  • Phone: 781-740-0100
  • Fax: 781-740-4590

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number13643
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: