Provider Demographics
NPI:1780999789
Name:SHELADIA, RAJVI MEHTA (DDS)
Entity type:Individual
Prefix:DR
First Name:RAJVI
Middle Name:MEHTA
Last Name:SHELADIA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:RAJVI
Other - Middle Name:JAGATKUMAR
Other - Last Name:MEHTA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:4 E. ROLLING CROSSROADS. ST. #205
Mailing Address - Street 2:
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228
Mailing Address - Country:US
Mailing Address - Phone:410-719-7900
Mailing Address - Fax:410-479-1714
Practice Address - Street 1:4 E. ROLLING CROSSROADS ST #205
Practice Address - Street 2:
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228
Practice Address - Country:US
Practice Address - Phone:410-719-7900
Practice Address - Fax:410-754-7719
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-13
Last Update Date:2012-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLL596122300000X
MD146601223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist