Provider Demographics
NPI:1295353696
Name:KSHATRI, DHIREN (DDS)
Entity type:Individual
Prefix:
First Name:DHIREN
Middle Name:
Last Name:KSHATRI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3113 VERA VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37064-2105
Mailing Address - Country:US
Mailing Address - Phone:423-322-6938
Mailing Address - Fax:
Practice Address - Street 1:350 S LOWE AVE
Practice Address - Street 2:
Practice Address - City:COOKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:38501-3567
Practice Address - Country:US
Practice Address - Phone:931-528-5105
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-12
Last Update Date:2020-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN11344122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist