Provider Demographics
NPI:1821449901
Name:GUJARAN, SHWETA DAYANAND
Entity Type:Individual
Prefix:DR
First Name:SHWETA
Middle Name:DAYANAND
Last Name:GUJARAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 ABBEY LN
Mailing Address - Street 2:UNIT 1409
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06810-5125
Mailing Address - Country:US
Mailing Address - Phone:516-633-5743
Mailing Address - Fax:
Practice Address - Street 1:72 NEWTOWN RD
Practice Address - Street 2:
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06810-6254
Practice Address - Country:US
Practice Address - Phone:516-633-5743
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-29
Last Update Date:2016-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT116531223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice