Provider Demographics
NPI:1225276256
Name:AGADI, SHILPA (DDS)
Entity Type:Individual
Prefix:
First Name:SHILPA
Middle Name:
Last Name:AGADI
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 1:951 W ROUND GROVE RD STE 300
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75067-7997
Mailing Address - Country:US
Mailing Address - Phone:469-702-2250
Mailing Address - Fax:469-702-2260
Practice Address - Street 1:951 W ROUND GROVE RD STE 300
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75067-7997
Practice Address - Country:US
Practice Address - Phone:469-702-2250
Practice Address - Fax:469-702-2260
Is Sole Proprietor?:No
Enumeration Date:2009-01-29
Last Update Date:2021-04-12
Deactivation Date:2021-03-01
Deactivation Code:
Reactivation Date:2021-03-22
Provider Licenses
StateLicense IDTaxonomies
TX308721223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice