Shenouda Abdelshahed
Individual provider Active NPI Dentist · Irving, TX
NPI 1962070730 · NPPES record last updated May 3, 2023
Key facts
- NPI
- 1962070730
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 39332 (TX)
- Practice address
- 3351 Regent Blvd Ste 120
Irving, TX 75063-3110 - Phone
- (214) 441-1000
- NPI assigned
- Jun 16, 2021
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D-0006904-C1 | AL | MD | Dentist |
| 39332 | TX | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hirsowitz DMD PLLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | D-0006904-C1 | AL | |
| Dentist | 122300000X | 39332 | TX | Yes |
Addresses
Primary practice location
3351 Regent Blvd Ste 120
Irving, TX 75063-3110
Mailing address
2757 Green Springs Hwy
Birmingham, AL 35209-4903
Other practice location 1
2757 Green Springs Hwy
Birmingham, AL 35209-4903
Phone (205) 379-7020
Other providers in Irving, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 3, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.