=====================================================
General NPI Number Information
=====================================================
NPI Number | 1790119741
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HST PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/27/2013
-----------------------------------------------------
Last Update Date | 06/27/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3701 W NORTHWEST HWY SUITE #306
-----------------------------------------------------
City | DALLAS
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75220-4955
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 214-353-0683
-----------------------------------------------------
Fax | 972-764-8760
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3701 W NORTHWEST HWY SUITE #306
-----------------------------------------------------
City | DALLAS
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75220-4962
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 214-353-0683
-----------------------------------------------------
Fax | 972-764-8760
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRACTICE OWNER
-----------------------------------------------------
Name | MR. HAMID KASHANI
-----------------------------------------------------
Credential | DDS
-----------------------------------------------------
Telephone | 214-353-0683
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223G0001X
-----------------------------------------------------
Taxonomy Name | General Practice Dentistry
-----------------------------------------------------
License Number | 28391
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------