MEDICARE: ABHIKUMAR SHINGALA DMD

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	122300000X	Dentist	DN123554	GA

General Provider Information

NPI Number	:	1750108007
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ABHIKUMAR SHINGALA DMD

Provider Business Mailing Address
First Line	:	707 WHITLOCK AVE SW STE C25
Second Line	:
City	:	MARIETTA
State	:	GA
Zip	:	30064-4655
Country	:	US
Telephone Number	:	770-422-7727
Fax Number	:

Provider Business Practice Location Address
First Line	:	707 WHITLOCK AVE SW STE C25
Second Line	:
City	:	MARIETTA
State	:	GA
Zip	:	30064-4655
Country	:	US
Telephone Number	:	770-422-7727
Fax Number	:

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

Provider Enumeration Date	:	09/26/2024
Last Update Date	:	09/26/2024

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