Healthcare Provider Details

I. General information

NPI: 1528988045
Provider Name (Legal Business Name): SHAINA UPPAL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/16/2026
Last Update Date: 07/16/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22901 MILL CREEK BOULEVARD, SUITE 200
BEECHWOOD OH
44122
US

IV. Provider business mailing address

CLEVELAND DENTAL INSTITUTE 22901 MILLCREEK BLVD, STE 200
BEACHWOOD OH
44122
US

V. Phone/Fax

Practice location:
  • Phone: 216-727-0234
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberRES.005109
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: