Provider Demographics
NPI:1821102955
Name:SHAH, DARSHIKA B (DDS)
Entity Type:Individual
Prefix:MRS
First Name:DARSHIKA
Middle Name:B
Last Name:SHAH
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 1:38921 DEQUINDRE RD
Mailing Address - Street 2:105
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48083
Mailing Address - Country:US
Mailing Address - Phone:248-879-7755
Mailing Address - Fax:248-879-4526
Practice Address - Street 1:38921 DEQUINDRE RD
Practice Address - Street 2:105
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48083
Practice Address - Country:US
Practice Address - Phone:248-879-7755
Practice Address - Fax:248-879-4526
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIOD16671122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3527275Medicaid