Provider Demographics
NPI:1750108007
Name:SHINGALA, ABHIKUMAR (DMD)
Entity type:Individual
Prefix:
First Name:ABHIKUMAR
Middle Name:
Last Name:SHINGALA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:707 WHITLOCK AVE SW STE C25
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30064-4655
Mailing Address - Country:US
Mailing Address - Phone:770-422-7727
Mailing Address - Fax:
Practice Address - Street 1:707 WHITLOCK AVE SW STE C25
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30064-4655
Practice Address - Country:US
Practice Address - Phone:770-422-7727
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-26
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN123554122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist