Provider Demographics
NPI:1962627331
Name:FERREIRA, SHIRLEY S (DDS)
Entity Type:Individual
Prefix:
First Name:SHIRLEY
Middle Name:S
Last Name:FERREIRA
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 1:7225 US 31 S
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46227-8685
Mailing Address - Country:US
Mailing Address - Phone:317-300-0356
Mailing Address - Fax:
Practice Address - Street 1:7225 US 31 S
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46227-8685
Practice Address - Country:US
Practice Address - Phone:317-300-0356
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-13
Last Update Date:2016-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2572122300000X
IN12011892A122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist