Individual
ASHUTOSH SHRIVASTAVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
340 KELLEY PKWY, MEXICO, MO 65265-3811
(573) 582-1234
Mailing address
340 KELLEY PKWY, MEXICO, MO 65265-3811
(573) 582-1234
(573) 582-1212
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2015010832
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03778627
—
NY
05
—
400157835
—
MO
Enumeration date
07/12/2011
Last updated
03/02/2026
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