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NPI Code Detail

MEDICARE: SHALINI SANKU

MEDICARE:   SHALINI  SANKU
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
1122300000XDentist27315TX
2122300000XDentist6880OK
31223G0001XGeneral Practice Dentistry6880OK

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1407085269
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHALINI SANKU
Provider Business Mailing Address
First Line : 1200 S AIR DEPOT BLVD
Second Line :
City : MIDWEST CITY
State : OK
Zip : 73110-4866
Country : US
Telephone Number : 405-494-8092
Fax Number :
Provider Business Practice Location Address
First Line : 1200 S AIR DEPOT BLVD
Second Line :
City : MIDWEST CITY
State : OK
Zip : 73110-4866
Country : US
Telephone Number : 405-494-8092
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/14/2009
Last Update Date : 11/14/2016

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Directions to “ SHALINI SANKU ” Practice Location

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