Provider Demographics
NPI:1851520779
Name:NESARIKAR, SHALAKA ABHIJIT (DDS)
Entity Type:Individual
Prefix:DR
First Name:SHALAKA
Middle Name:ABHIJIT
Last Name:NESARIKAR
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 1:8025 AMBIANCE WAY
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-6839
Mailing Address - Country:US
Mailing Address - Phone:469-688-3171
Mailing Address - Fax:
Practice Address - Street 1:2736 VALLEY VIEW LN STE 300
Practice Address - Street 2:
Practice Address - City:FARMERS BRANCH
Practice Address - State:TX
Practice Address - Zip Code:75234-4969
Practice Address - Country:US
Practice Address - Phone:972-241-1352
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-13
Last Update Date:2020-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX211441223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice