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General NPI Number Information
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NPI Number | 1043652878
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Entity Type | Organization
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Legal Business Name | SHIRLEY IRUDAYARAJ DDS INC
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Dates
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Enumeration Date | 07/22/2013
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Last Update Date | 07/22/2013
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Provider Practice Location Address
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Address Line | 877 W FREMONT AVE STE L1
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City | SUNNYVALE
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State | CA
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Zip | 94087-2332
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Country | US
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Telephone | 408-498-0244
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Fax | 408-498-0246
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Provider Business Mailing Address
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Address Line | 877 W FREMONT AVE STE L1
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City | SUNNYVALE
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State | CA
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Zip | 94087-2332
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Country | US
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Telephone | 408-498-0244
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Fax | 408-498-0246
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Authorized Official
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Title or Position | OWNER/DENTIST
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Name | SHIRLEY IRUDAYARAJ
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Credential | DDS
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Telephone | 408-498-0244
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 51478
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License Number State | CA
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