Provider Demographics
NPI:1548157597
Name:SHRIMANKAR, KRISHA ANIL
Entity type:Individual
Prefix:
First Name:KRISHA
Middle Name:ANIL
Last Name:SHRIMANKAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2681 ROOSEVELT BLVD APT 2309
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33760-2968
Mailing Address - Country:US
Mailing Address - Phone:815-603-6776
Mailing Address - Fax:
Practice Address - Street 1:616 ROBIN RD
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33803-4841
Practice Address - Country:US
Practice Address - Phone:863-277-6891
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-23
Last Update Date:2025-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN30421122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist