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General NPI Number Information
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NPI Number | 1871010165
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Entity Type | Individual
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Provider Name | MAYANK SHRIVASTAVA BDS, MDS
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Gender | Male
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Dates
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Enumeration Date | 08/28/2017
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Last Update Date | 06/18/2025
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Provider Practice Location Address
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Address Line | 2050 FIRST DENTAL BUILDING CB 7450
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City | CHAPEL HILL
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State | NC
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Zip | 27599-7450
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Country | US
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Telephone | 919-537-3939
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Fax | 919-537-3856
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Provider Business Mailing Address
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Address Line | 140 DENTAL CIRCLE CB 7450
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City | CHAPEL HILL
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State | NC
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Zip | 27599-7450
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Country | US
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Telephone | 919-537-3290
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Fax | 919-537-3856
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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 | 14049
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 1223X2210X
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Taxonomy Name | Orofacial Pain Dentistry
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License Number | 14049
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License Number State | NC
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