Provider Demographics
NPI:1063731198
Name:SHEFALI PANDYA, D.M.D., P.A.
Entity type:Organization
Organization Name:SHEFALI PANDYA, D.M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SHEFALI
Authorized Official - Middle Name:
Authorized Official - Last Name:PANDYA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:302-421-9960
Mailing Address - Street 1:707 FOULK RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19803-3737
Mailing Address - Country:US
Mailing Address - Phone:302-421-9960
Mailing Address - Fax:302-421-9970
Practice Address - Street 1:707 FOULK RD
Practice Address - Street 2:SUITE 201
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19803-3737
Practice Address - Country:US
Practice Address - Phone:302-421-9960
Practice Address - Fax:302-421-9970
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-28
Last Update Date:2010-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEG1-0001124122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty