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General NPI Number Information
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NPI Number | 1104302124
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Entity Type | Individual
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Provider Name | SHALINI MITTAL DDS
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Gender | Female
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Dates
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Enumeration Date | 07/12/2018
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Last Update Date | 10/02/2025
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Provider Practice Location Address
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Address Line | 1468 E WHITESTONE BLVD STE 500
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City | CEDAR PARK
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State | TX
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Zip | 78613-0019
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Country | US
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Telephone | 612-584-7767
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Fax |
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Provider Business Mailing Address
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Address Line | 2618 KRAMER LN APT 5091
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City | AUSTIN
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State | TX
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Zip | 78758-0073
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Country | US
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Telephone | 612-584-7767
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 14131
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 38304
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DEN1001884
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License Number State | DC
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