Provider Demographics
NPI:1831874544
Name:RUPANI, SHADAAN ASLAM (DDS)
Entity type:Individual
Prefix:
First Name:SHADAAN
Middle Name:ASLAM
Last Name:RUPANI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5242 MEADOW LANDING LN
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-4293
Mailing Address - Country:US
Mailing Address - Phone:832-363-7269
Mailing Address - Fax:
Practice Address - Street 1:1006 N WELLS ST
Practice Address - Street 2:
Practice Address - City:EDNA
Practice Address - State:TX
Practice Address - Zip Code:77957-2151
Practice Address - Country:US
Practice Address - Phone:361-235-4226
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-20
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX39518122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice