Healthcare Provider Details

I. General information

NPI: 1427960145
Provider Name (Legal Business Name): DR. HEENA SHRIVASTAVA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/18/2026
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

158 W FM 544 STE 126
MURPHY TX
75094-4800
US

IV. Provider business mailing address

1017 MIDLAND DR
ALLEN TX
75013-3378
US

V. Phone/Fax

Practice location:
  • Phone: 972-472-8862
  • Fax:
Mailing address:
  • Phone: 214-208-4424
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number42637
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: