Provider Demographics
NPI:1437860376
Name:SHRIJANA SHAKYA DDS INC
Entity Type:Organization
Organization Name:SHRIJANA SHAKYA DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHRIJANA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAKYA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:334-557-9134
Mailing Address - Street 1:2754 TRAILSIDE LN
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94518-2188
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5100 CLAYTON RD STE A19
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94521-3131
Practice Address - Country:US
Practice Address - Phone:925-414-4128
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-12
Last Update Date:2022-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental