MEDICARE: SUJIT SHAKYA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	DN29603	FL

General Provider Information

NPI Number	:	1053146894
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUJIT SHAKYA

Provider Business Mailing Address
First Line	:	4501 45TH WAY
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33407-6845
Country	:	US
Telephone Number	:	857-919-0988
Fax Number	:

Provider Business Practice Location Address
First Line	:	4501 45TH WAY
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33407-6845
Country	:	US
Telephone Number	:	857-919-0988
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/03/2024
Last Update Date	:	09/03/2024

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Directions to “ SUJIT SHAKYA ” Practice Location

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