Provider Demographics
NPI:1497290043
Name:CHAUHAN, SHALABH (DDS)
Entity Type:Individual
Prefix:
First Name:SHALABH
Middle Name:
Last Name:CHAUHAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2536 E 10TH ST
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46201-2155
Mailing Address - Country:US
Mailing Address - Phone:317-983-1200
Mailing Address - Fax:317-983-1201
Practice Address - Street 1:2536 E 10TH ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46201-2155
Practice Address - Country:US
Practice Address - Phone:317-983-1200
Practice Address - Fax:317-983-1201
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-05
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1001466122300000X
IN12013056A1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist