MEDICARE: MR. SHASHANK KRISHNAJI DENGLE MD

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	207RC0000X	Cardiovascular Disease Physician	H1686	TX
2	207R00000X	Internal Medicine Physician	H1686	TX
3	207RC0000X	Cardiovascular Disease Physician	D0106472	MD

Other Identifiers

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

General Provider Information

NPI Number	:	1912088527
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. SHASHANK KRISHNAJI DENGLE MD

Provider Business Mailing Address
First Line	:	874 ED HALL DR STE 111
Second Line	:
City	:	KAUFMAN
State	:	TX
Zip	:	75142-1800
Country	:	US
Telephone Number	:	972-932-4800
Fax Number	:	972-932-7959

Provider Business Practice Location Address
First Line	:	874 ED HALL DR STE 111
Second Line	:
City	:	KAUFMAN
State	:	TX
Zip	:	75142-1800
Country	:	US
Telephone Number	:	972-932-4800
Fax Number	:	972-932-7959

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

Provider Enumeration Date	:	10/18/2006
Last Update Date	:	06/04/2026

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