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General NPI Number Information
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NPI Number | 1013427095
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Entity Type | Individual
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Provider Name | SHILPA AGARWAL
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Gender | Female
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Dates
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Enumeration Date | 10/04/2017
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Last Update Date | 10/04/2017
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Provider Practice Location Address
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Address Line | 3658 S EAST ST
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City | INDIANAPOLIS
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State | IN
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Zip | 46227-1239
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Country | US
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Telephone | 317-781-5667
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Fax | 317-781-5666
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Provider Business Mailing Address
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Address Line | 12764 EDGEMONT WAY
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City | CARMEL
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State | IN
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Zip | 46032-7296
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Country | US
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Telephone | 617-992-0658
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 12012831A
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License Number State | IN
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