Provider Demographics
NPI:1689706046
Name:SAGI, SHALINI (DDS)
Entity Type:Individual
Prefix:DR
First Name:SHALINI
Middle Name:
Last Name:SAGI
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 1:5819 -21 EAST RIVERSIDE BLVD
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61114
Mailing Address - Country:US
Mailing Address - Phone:815-637-2273
Mailing Address - Fax:815-637-2466
Practice Address - Street 1:5819 -21 EAST RIVERSIDE BLVD
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61114
Practice Address - Country:US
Practice Address - Phone:815-637-2273
Practice Address - Fax:815-637-2466
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist