Provider Demographics
NPI:1336290246
Name:SHETTY, SAJINI (DMD)
Entity Type:Individual
Prefix:DR
First Name:SAJINI
Middle Name:
Last Name:SHETTY
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 1:61 WILDWOOD RD
Mailing Address - Street 2:
Mailing Address - City:ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01810-5729
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:297 DANIEL WEBSTER HWY
Practice Address - Street 2:SUITE 6
Practice Address - City:MERRIMACK
Practice Address - State:NH
Practice Address - Zip Code:03054-4451
Practice Address - Country:US
Practice Address - Phone:603-429-2199
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2008-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH03636122300000X
MA20321122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist