Provider Demographics
NPI:1184249427
Name:JOSHI, SHILPA DHANANJAY (DMD, MA)
Entity type:Individual
Prefix:DR
First Name:SHILPA
Middle Name:DHANANJAY
Last Name:JOSHI
Suffix:
Gender:F
Credentials:DMD, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26W172 WATERBURY CT
Mailing Address - Street 2:
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60187-1306
Mailing Address - Country:US
Mailing Address - Phone:630-408-6107
Mailing Address - Fax:
Practice Address - Street 1:16345 HARLEM AVE STE 150
Practice Address - Street 2:
Practice Address - City:TINLEY PARK
Practice Address - State:IL
Practice Address - Zip Code:60477-2566
Practice Address - Country:US
Practice Address - Phone:708-633-8700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-12
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
IL021.0032001223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program