Provider Demographics
NPI:1770258444
Name:AGGARWAL, SHAILY (DDS)
Entity Type:Individual
Prefix:DR
First Name:SHAILY
Middle Name:
Last Name:AGGARWAL
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 1:860 SAN CARLOS CT
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94539-3610
Mailing Address - Country:US
Mailing Address - Phone:650-279-1326
Mailing Address - Fax:
Practice Address - Street 1:860 SAN CARLOS CT
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94539-3610
Practice Address - Country:US
Practice Address - Phone:650-279-1326
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-13
Last Update Date:2021-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1066951223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NAOtherNA