Provider Demographics
NPI:1770509101
Name:SHANKER, SHIVA (DDS)
Entity Type:Individual
Prefix:DR
First Name:SHIVA
Middle Name:
Last Name:SHANKER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7242 TYLERS CORNER DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:WEST CHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45069-6334
Mailing Address - Country:US
Mailing Address - Phone:513-777-7060
Mailing Address - Fax:
Practice Address - Street 1:7242 TYLERS CORNER DR
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45069-6334
Practice Address - Country:US
Practice Address - Phone:513-777-7060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-15
Last Update Date:2010-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH300205831223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics