Healthcare Provider Details

I. General information

NPI: 1003738329
Provider Name (Legal Business Name): DR. SHEFALI SAVARIRAYAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1771 CAPITAL CIR NE
TALLAHASSEE FL
32308-5517
US

IV. Provider business mailing address

10655 BRIGHTMAN BLVD
JACKSONVILLE FL
32246-7537
US

V. Phone/Fax

Practice location:
  • Phone: 850-765-3748
  • Fax:
Mailing address:
  • Phone: 724-322-4164
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number29664
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: