Provider Demographics
NPI:1952385775
Name:TRIVEDI, SHILPA RUSHIKESH (DDS)
Entity Type:Individual
Prefix:DR
First Name:SHILPA
Middle Name:RUSHIKESH
Last Name:TRIVEDI
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 1:5117 PARSONS BLVD
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-2333
Mailing Address - Country:US
Mailing Address - Phone:718-359-7819
Mailing Address - Fax:718-445-7608
Practice Address - Street 1:14610 45TH AVE
Practice Address - Street 2:PREFERRED DENTAL CARE
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-2234
Practice Address - Country:US
Practice Address - Phone:718-445-7600
Practice Address - Fax:718-445-7608
Is Sole Proprietor?:No
Enumeration Date:2005-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY043087-11223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice