Provider Demographics
NPI:1447539275
Name:MEHTA, SHIBANI DALAL (DDS)
Entity type:Individual
Prefix:DR
First Name:SHIBANI
Middle Name:DALAL
Last Name:MEHTA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14544 WHITTIER BLVD
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90605-2129
Mailing Address - Country:US
Mailing Address - Phone:562-698-9855
Mailing Address - Fax:
Practice Address - Street 1:14544 WHITTIER BLVD
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90605-2129
Practice Address - Country:US
Practice Address - Phone:562-698-9855
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-10
Last Update Date:2022-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA606341223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice