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General NPI Number Information
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NPI Number | 1316492713
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Entity Type | Individual
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Provider Name | SHWETA UJAONEY THACKERAY D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 08/16/2016
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Last Update Date | 02/12/2026
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Provider Practice Location Address
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Address Line | 41 DABNEYS MILL RD
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City | MANQUIN
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State | VA
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Zip | 23106-2508
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Country | US
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Telephone | 817-600-4560
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Fax |
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Provider Business Mailing Address
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Address Line | 11805 MASON PARK WAY
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City | GLEN ALLEN
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State | VA
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Zip | 23059-5828
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Country | US
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Telephone | 817-600-4560
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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 | 0401415306
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License Number State | VA
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