Provider Demographics
NPI:1619297199
Name:ACHANTI, SHALINI (DDS)
Entity Type:Individual
Prefix:
First Name:SHALINI
Middle Name:
Last Name:ACHANTI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:SHALINI
Other - Middle Name:
Other - Last Name:UPPALAPATI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1585 N MCCARTHY RD
Mailing Address - Street 2:APT#4
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54913
Mailing Address - Country:US
Mailing Address - Phone:414-721-1379
Mailing Address - Fax:
Practice Address - Street 1:1585 N MCCARTHY RD
Practice Address - Street 2:APT#4
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54913-8448
Practice Address - Country:US
Practice Address - Phone:414-721-1379
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-07
Last Update Date:2010-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program