Provider Demographics
NPI:1396962262
Name:SHIKH, SATPAL (DMD)
Entity type:Individual
Prefix:
First Name:SATPAL
Middle Name:
Last Name:SHIKH
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 1:220 RENAISSANCE PKWY NE
Mailing Address - Street 2:#2117
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30308-2339
Mailing Address - Country:US
Mailing Address - Phone:678-772-8900
Mailing Address - Fax:
Practice Address - Street 1:1745 HIGHWAY 138 SE STE C3
Practice Address - Street 2:
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30013-5710
Practice Address - Country:US
Practice Address - Phone:770-393-9111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN-0128471223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice