Provider Demographics
NPI:1558440958
Name:SHAH, VARSHA UDAYAN (DDS)
Entity Type:Individual
Prefix:MRS
First Name:VARSHA
Middle Name:UDAYAN
Last Name:SHAH
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6355 TEN OAKS RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:CLARKSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21029-1184
Mailing Address - Country:US
Mailing Address - Phone:410-531-2600
Mailing Address - Fax:410-531-2694
Practice Address - Street 1:6355 TEN OAKS RD
Practice Address - Street 2:SUITE 201
Practice Address - City:CLARKSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21029-1184
Practice Address - Country:US
Practice Address - Phone:410-531-2600
Practice Address - Fax:410-531-2694
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDMD11088122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist