Healthcare Provider Details

I. General information

NPI: 1881487130
Provider Name (Legal Business Name): DIKSHITHA M SHANKAR DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2025
Last Update Date: 06/09/2025
Certification Date: 06/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

344 UNIVERSITY BLVD W
SILVER SPRING MD
20901-1948
US

IV. Provider business mailing address

1100 ALABAMA AVE SE
WASHINGTON DC
20032-4542
US

V. Phone/Fax

Practice location:
  • Phone: 844-796-2797
  • Fax:
Mailing address:
  • Phone: 202-299-5610
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDEN2001565
License Number StateDC

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: