Individual provider Active NPI

Mishleen Maurice Bashour, DDS

  • Dentist
  • Allentown, PA
National Provider Identifier
1023799632
Registry record updated Aug 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DS044321 Issued in PA
Practice address
750 N Krocks Rd Ste 206
Allentown, PA 18106-9079
Phone
(610) 530-7785
NPI assigned
Jul 26, 2023
Last updated
Aug 30, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Dentist 122300000X DS044321 PA Primary

Addresses

Primary practice location

750 N Krocks Rd Ste 206
Allentown, PA 18106-9079

Mailing address

1124 N Kearney St
Allentown, PA 18109-3326
Phone (484) 951-2612

Other practice location 1

1856 Airport Rd
Allentown, PA 18109-9545
Phone (610) 437-2211

Other practice location 2

817 S 25th St
Easton, PA 18045-5376
Phone (610) 330-9855

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DS044321PAMDDentist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1690329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693353600000",
    "number": "1023799632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1124 N KEARNEY ST",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181093326",
            "telephone_number": "484-951-2612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 N KROCKS RD STE 206",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181069079",
            "telephone_number": "610-530-7785"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1856 Airport Rd",
            "address_purpose": "LOCATION",
            "city": "Allentown",
            "state": "PA",
            "postal_code": "181099545",
            "country_code": "US",
            "telephone_number": "610-437-2211",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "817 S 25th St",
            "address_purpose": "LOCATION",
            "city": "Easton",
            "state": "PA",
            "postal_code": "180455376",
            "country_code": "US",
            "telephone_number": "610-330-9855",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BASHOUR",
        "first_name": "MISHLEEN",
        "middle_name": "MAURICE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-26",
        "last_updated": "2023-08-30",
        "certification_date": "2023-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS044321",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Allentown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.