Active NPI
Shaista Hasan, DMD
- Dentist
- Wilkes Barre Township, PA
National Provider Identifier
1831796853
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DS042929
- Practice address
- 29 Bear Creek Blvd
Wilkes Barre Township, PA 18702-7803 - Phone
- (570) 825-8090
- NPI assigned
- Oct 2, 2020
- Last updated
- Jun 15, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DS042929 | PA | Primary |
Addresses
Primary practice location
29 Bear Creek Blvd
Wilkes Barre Township, PA 18702-7803
Mailing address
29 Bear Creek Blvd
Wilkes Barre Township, PA 18702-7803
Phone (570) 825-8090
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
| License | State | Type | Specialty |
|---|---|---|---|
| DS042929 | PA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1601596800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1623715200000",
"number": "1831796853",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "29 BEAR CREEK BLVD",
"city": "WILKES BARRE TOWNSHIP",
"state": "PA",
"postal_code": "187027803",
"telephone_number": "570-825-8090"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "29 BEAR CREEK BLVD",
"city": "WILKES BARRE TOWNSHIP",
"state": "PA",
"postal_code": "187027803",
"telephone_number": "570-825-8090"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HASAN",
"first_name": "SHAISTA",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-10-02",
"last_updated": "2021-06-15",
"certification_date": "2021-06-15",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "PA",
"license": "DS042929",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wilkes Barre Township, PA
- Affordable Dentures & Implants of Pennsylvania, PLLC (Affordable Dentures & Implants - Wilkes Barre)
- Joanne F Allen, LPT
- Francis Cantafio, LPT
- Christine Crooks, PTA
- John Heinz Institute of Rehabilitation Medicine (Heinz Transitional Rehabilitation Unit)
- Amanda Nicole Kapes, L.S.W. & BCBA
- Christopher Matthew Krzak, ATC
- Stephen J Kulikowski, PT
- Sally Ann Metzloff, MSPT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.