Provider Demographics
NPI:1245021591
Name:SHRESTHA, ANJILA (DMD)
Entity type:Individual
Prefix:DR
First Name:ANJILA
Middle Name:
Last Name:SHRESTHA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:668 HERITAGE LN W
Mailing Address - Street 2:
Mailing Address - City:TERRE HAUTE
Mailing Address - State:IN
Mailing Address - Zip Code:47803-1383
Mailing Address - Country:US
Mailing Address - Phone:914-427-3279
Mailing Address - Fax:
Practice Address - Street 1:1792 IN-163
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:IN
Practice Address - Zip Code:47842
Practice Address - Country:US
Practice Address - Phone:765-832-7741
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-15
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program