Provider Demographics
NPI:1629407770
Name:NILESHWAR, SHILPA (DDS)
Entity Type:Individual
Prefix:DR
First Name:SHILPA
Middle Name:
Last Name:NILESHWAR
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 1:210 BEAULLIEU DR
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-7226
Mailing Address - Country:US
Mailing Address - Phone:337-984-4747
Mailing Address - Fax:337-984-4751
Practice Address - Street 1:210 BEAULLIEU DR
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-7226
Practice Address - Country:US
Practice Address - Phone:337-984-4747
Practice Address - Fax:337-984-4751
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-08
Last Update Date:2013-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA64201223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry