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NPI Code Detail

MEDICARE: SHREYA IYENGAR

MEDICARE:   SHREYA  IYENGAR
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
11223X0400XOrthodontics and Dentofacial Orthopedics DentistryDRP2671FL

General Provider Information

NPI Number : 1538011705
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHREYA IYENGAR
Provider Business Mailing Address
First Line : 9825 GATE PKWY N APT 2115
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32246-9245
Country : US
Telephone Number : 617-412-9070
Fax Number :
Provider Business Practice Location Address
First Line : 5491 DOLPHIN POINT BLVD
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32211-3221
Country : US
Telephone Number : 904-256-7846
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/11/2026
Last Update Date : 02/11/2026

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Directions to “ SHREYA IYENGAR ” Practice Location

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