Individual
SHILPA JAIN CHANDIWAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S, B.D.S
Contact information
Practice address
167 CITADEL WAY STE 100, SUGAR LAND, TX 77479-7162
(713) 955-2100
(713) 904-1806
Mailing address
167 CITADEL WAY STE 100, SUGAR LAND, TX 77479-7162
(713) 955-2100
(713) 904-1806
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
25305
TX
1223P0221X
Pediatric Dentistry
Primary
25305
TX
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
25305
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
218348510
—
TX
Enumeration date
09/17/2008
Last updated
08/29/2022
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