Provider Demographics
NPI:1821438334
Name:SHEKHADIYA, RAJIV B (DDS)
Entity Type:Individual
Prefix:
First Name:RAJIV
Middle Name:B
Last Name:SHEKHADIYA
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 1:3604 S W S YOUND DR
Mailing Address - Street 2:314
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76542
Mailing Address - Country:US
Mailing Address - Phone:248-275-3292
Mailing Address - Fax:
Practice Address - Street 1:4250 CLEAR CREEK ROAD, # 213
Practice Address - Street 2:FORT HOOD EXCHANGE SHOPPING CENTER
Practice Address - City:FORT HOOD
Practice Address - State:TX
Practice Address - Zip Code:76544
Practice Address - Country:US
Practice Address - Phone:254-285-2014
Practice Address - Fax:254-285-2182
Is Sole Proprietor?:No
Enumeration Date:2013-06-28
Last Update Date:2015-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX30698122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist