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General NPI Number Information
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NPI Number | 1427504828
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Entity Type | Individual
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Provider Name | SHASHANK JOSHI BDS, MS
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Gender | Male
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Dates
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Enumeration Date | 08/26/2016
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Last Update Date | 10/31/2019
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Provider Practice Location Address
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Address Line | 1739 W HARVARD AVE
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City | ROSEBURG
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State | OR
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Zip | 97471-2716
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Country | US
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Telephone | 646-464-4447
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Fax |
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Provider Business Mailing Address
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Address Line | 811 HOLLINS ST APT 3
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City | BALTIMORE
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State | MD
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Zip | 21201-1003
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Country | US
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Telephone |
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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 | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | D11144
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License Number State | OR
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