Provider Demographics
NPI:1043384845
Name:KAUL, SHEVATA (DDS)
Entity Type:Individual
Prefix:
First Name:SHEVATA
Middle Name:
Last Name:KAUL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14115 LARKSPUR DR
Mailing Address - Street 2:
Mailing Address - City:SHELBY TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48315
Mailing Address - Country:US
Mailing Address - Phone:248-495-5801
Mailing Address - Fax:
Practice Address - Street 1:17700 MACK AVENUE
Practice Address - Street 2:
Practice Address - City:GROSSE POINTE
Practice Address - State:MI
Practice Address - Zip Code:48224
Practice Address - Country:US
Practice Address - Phone:313-882-2211
Practice Address - Fax:313-882-5434
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901019232122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist