Provider Demographics
NPI:1225048572
Name:SHALIT, JULIA ALEX (DDS)
Entity Type:Individual
Prefix:DR
First Name:JULIA
Middle Name:ALEX
Last Name:SHALIT
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9124 TECHNOLOGY DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46038-3064
Mailing Address - Country:US
Mailing Address - Phone:317-849-3444
Mailing Address - Fax:317-849-2555
Practice Address - Street 1:9124 TECHNOLOGY DR
Practice Address - Street 2:SUITE 200
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46038-3064
Practice Address - Country:US
Practice Address - Phone:317-849-3444
Practice Address - Fax:317-849-2555
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12010761A1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice