Provider Demographics
NPI:1740466283
Name:SHANKAR, RASHMI J (DDS)
Entity type:Individual
Prefix:
First Name:RASHMI
Middle Name:J
Last Name:SHANKAR
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11883 AMETHYST RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:VICTORVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:92392
Mailing Address - Country:US
Mailing Address - Phone:760-998-2066
Mailing Address - Fax:760-998-2067
Practice Address - Street 1:19276 MONTEREY ST
Practice Address - Street 2:
Practice Address - City:APPLE VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92308-6097
Practice Address - Country:US
Practice Address - Phone:760-995-0003
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-15
Last Update Date:2014-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30022071122300000X
CA54209122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist