Provider Demographics
NPI:1427336122
Name:KANT, SHIVANI S (DDS)
Entity type:Individual
Prefix:DR
First Name:SHIVANI
Middle Name:S
Last Name:KANT
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 1:107 181ST ST SW
Mailing Address - Street 2:
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98012-6233
Mailing Address - Country:US
Mailing Address - Phone:425-772-3292
Mailing Address - Fax:
Practice Address - Street 1:520 128TH ST SW STE A12
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98204-9350
Practice Address - Country:US
Practice Address - Phone:425-772-3292
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-28
Last Update Date:2011-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE60223508122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist