Provider Demographics
NPI:1336306273
Name:SHANKAR, SUNILA PATEL (DMD)
Entity Type:Individual
Prefix:DR
First Name:SUNILA
Middle Name:PATEL
Last Name:SHANKAR
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 1:1035 MERRIMAN ROAD
Mailing Address - Street 2:
Mailing Address - City:WESTLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48186-5311
Mailing Address - Country:US
Mailing Address - Phone:734-326-2200
Mailing Address - Fax:734-728-3030
Practice Address - Street 1:1035 MERRIMAN ROAD
Practice Address - Street 2:
Practice Address - City:WESTLAND
Practice Address - State:MI
Practice Address - Zip Code:48186-5311
Practice Address - Country:US
Practice Address - Phone:734-699-1808
Practice Address - Fax:734-699-3599
Is Sole Proprietor?:No
Enumeration Date:2008-05-19
Last Update Date:2015-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI187001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice