Provider Demographics
NPI:1275963993
Name:SHIVJI, ALIYAH (DMD)
Entity Type:Individual
Prefix:
First Name:ALIYAH
Middle Name:
Last Name:SHIVJI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 HOLLAND ST
Mailing Address - Street 2:UNIT 400
Mailing Address - City:SOMERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02144-2700
Mailing Address - Country:US
Mailing Address - Phone:617-764-3440
Mailing Address - Fax:
Practice Address - Street 1:20 HOLLAND ST
Practice Address - Street 2:UNIT 400
Practice Address - City:SOMERVILLE
Practice Address - State:MA
Practice Address - Zip Code:02144-2700
Practice Address - Country:US
Practice Address - Phone:617-764-3440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-15
Last Update Date:2016-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN18564291223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics