Provider Demographics
NPI:1346415932
Name:SHIKHMANTER, VLADISLAV (DDS)
Entity Type:Individual
Prefix:
First Name:VLADISLAV
Middle Name:
Last Name:SHIKHMANTER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:VLADISLAV
Other - Middle Name:
Other - Last Name:SHIKHMANTER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:184 ROUTE 9
Mailing Address - Street 2:
Mailing Address - City:ENGLISHTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07726-8454
Mailing Address - Country:US
Mailing Address - Phone:732-617-8411
Mailing Address - Fax:732-617-8412
Practice Address - Street 1:184 ROUTE 9
Practice Address - Street 2:
Practice Address - City:ENGLISHTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07726-8454
Practice Address - Country:US
Practice Address - Phone:732-617-8411
Practice Address - Fax:732-617-8412
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-24
Last Update Date:2008-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ20987122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist