Provider Demographics
NPI:1063844264
Name:PRIYADARSHINI, SHILPI (DDS)
Entity Type:Individual
Prefix:DR
First Name:SHILPI
Middle Name:
Last Name:PRIYADARSHINI
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 1:6235 LOVE DR
Mailing Address - Street 2:#127 GRAND VENETIAN
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75039-4075
Mailing Address - Country:US
Mailing Address - Phone:619-200-6684
Mailing Address - Fax:
Practice Address - Street 1:3030 LBJ FWY
Practice Address - Street 2:SUITE 1400
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75234-7781
Practice Address - Country:US
Practice Address - Phone:619-200-6684
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-30
Last Update Date:2019-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX29381122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist