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NPI Code Detail

MEDICARE: DR. SHIRLEY IRUDAYARAJ D.D.S

MEDICARE: DR. SHIRLEY IRUDAYARAJ D.D.S
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist51478CA

General Provider Information

NPI Number : 1356493910
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SHIRLEY IRUDAYARAJ D.D.S
Provider Business Mailing Address
First Line : 2534 DELL AVE
Second Line :
City : MOUNTAIN VIEW
State : CA
Zip : 94043-4149
Country : US
Telephone Number : 650-314-0061
Fax Number :
Provider Business Practice Location Address
First Line : 975 VETERANS BLVD
Second Line :
City : REDWOOD CITY
State : CA
Zip : 94063-1714
Country : US
Telephone Number : 650-365-8922
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/16/2007
Last Update Date : 07/08/2007

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