Provider Demographics
NPI:1720627243
Name:SHIVAM DENTAL LLC
Entity Type:Organization
Organization Name:SHIVAM DENTAL LLC
Other - Org Name:DENTAL EXCELLENCE OF HELLERTOWN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:RAJESH
Authorized Official - Middle Name:
Authorized Official - Last Name:KASWALA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:732-429-6911
Mailing Address - Street 1:6722 ARBORDEAU LN
Mailing Address - Street 2:
Mailing Address - City:MACUNGIE
Mailing Address - State:PA
Mailing Address - Zip Code:18062-8794
Mailing Address - Country:US
Mailing Address - Phone:732-429-6911
Mailing Address - Fax:
Practice Address - Street 1:800 MAIN STREET
Practice Address - Street 2:SUIT 102
Practice Address - City:HELLERTOWN
Practice Address - State:PA
Practice Address - Zip Code:18055
Practice Address - Country:US
Practice Address - Phone:610-838-6597
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SHIVAM DENTAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-01-01
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center