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General NPI Number Information
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NPI Number | 1720962004
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Entity Type | Individual
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Provider Name | SHIVANI TUMUKUNTALA DDS
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Gender | Female
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Dates
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Enumeration Date | 08/01/2025
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Last Update Date | 08/01/2025
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Provider Practice Location Address
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Address Line | 2891 MATLOCK RD
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City | MANSFIELD
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State | TX
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Zip | 76063-5382
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Country | US
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Telephone | 682-518-2350
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Fax |
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Provider Business Mailing Address
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Address Line | 15008 PIZARRO CT
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City | LITTLE ELM
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State | TX
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Zip | 75068-2499
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Country | US
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Telephone | 513-417-7668
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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 | 41745
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License Number State | TX
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