Provider Demographics
NPI:1063968303
Name:NAGELLI, SHALINI (DMD)
Entity type:Individual
Prefix:DR
First Name:SHALINI
Middle Name:
Last Name:NAGELLI
Suffix:
Gender:
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2115 UNIVERSITY DR STE 210
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75033-4801
Mailing Address - Country:US
Mailing Address - Phone:314-397-8041
Mailing Address - Fax:
Practice Address - Street 1:2115 UNIVERSITY DR STE 210
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75033-4801
Practice Address - Country:US
Practice Address - Phone:314-397-8041
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-28
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019030762122300000X
TX371571223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice