Healthcare Provider Details

I. General information

NPI: 1508132408
Provider Name (Legal Business Name): SHIVANI ANAND DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2012
Last Update Date: 01/27/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

122 SARATOGA AVE
SANTA CLARA CA
95051-7385
US

IV. Provider business mailing address

122 SARATOGA AVE
SANTA CLARA CA
95051-7385
US

V. Phone/Fax

Practice location:
  • Phone: 408-556-1333
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License NumberDDS100425
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: