Provider Demographics
NPI:1083955512
Name:SHIVASHANKARAPPA, ASHWINI (DDS)
Entity Type:Individual
Prefix:DR
First Name:ASHWINI
Middle Name:
Last Name:SHIVASHANKARAPPA
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 1:877 E SOUTH BOULDER RD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:CO
Mailing Address - Zip Code:80027-1345
Mailing Address - Country:US
Mailing Address - Phone:720-476-5504
Mailing Address - Fax:303-200-7375
Practice Address - Street 1:877 E SOUTH BOULDER RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:CO
Practice Address - Zip Code:80027-1345
Practice Address - Country:US
Practice Address - Phone:720-476-5504
Practice Address - Fax:303-200-7375
Is Sole Proprietor?:No
Enumeration Date:2013-03-07
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN.00201938122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist