MEDICARE: DR. ABDULMOHSIN HASSAN ALHASHIM DDS, MSD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223P0700X	Prosthodontics	DNF000419	GA
2	1223P0700X	Prosthodontics	S136	MN
3	1223P0700X	Prosthodontics	S5-58C	NV

General Provider Information

NPI Number	:	1215232103
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ABDULMOHSIN HASSAN ALHASHIM DDS, MSD

Provider Business Mailing Address
First Line	:	2318 MALONE WAY
Second Line	:
City	:	EVANS
State	:	GA
Zip	:	30809-5312
Country	:	US
Telephone Number	:	706-288-9448
Fax Number	:

Provider Business Practice Location Address
First Line	:	6780 S FORT APACHE RD STE 130
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89148-5405
Country	:	US
Telephone Number	:	725-235-9301
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/24/2011
Last Update Date	:	11/17/2022

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