Provider Demographics
NPI:1316907090
Name:AHUJA, SHALINI (DDS)
Entity type:Individual
Prefix:DR
First Name:SHALINI
Middle Name:
Last Name:AHUJA
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 1:12 CHATSWORTH WAY
Mailing Address - Street 2:
Mailing Address - City:CLIFTON PARK
Mailing Address - State:NY
Mailing Address - Zip Code:12065-7238
Mailing Address - Country:US
Mailing Address - Phone:212-844-9071
Mailing Address - Fax:
Practice Address - Street 1:12 CHATSWORTH WAY
Practice Address - Street 2:
Practice Address - City:CLIFTON PARK
Practice Address - State:NY
Practice Address - Zip Code:12065-7238
Practice Address - Country:US
Practice Address - Phone:212-844-9071
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-25
Last Update Date:2015-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY05062611223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02408762Medicaid