Provider Demographics
NPI:1982280301
Name:SHALINI CHITTAMURI LLC
Entity type:Organization
Organization Name:SHALINI CHITTAMURI LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICING DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHALINI
Authorized Official - Middle Name:
Authorized Official - Last Name:CHITTAMURI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-420-8804
Mailing Address - Street 1:15200 SHADY GROVE RD STE 340
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-6230
Mailing Address - Country:US
Mailing Address - Phone:301-330-4600
Mailing Address - Fax:301-330-0558
Practice Address - Street 1:15200 SHADY GROVE RD STE 340
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-6230
Practice Address - Country:US
Practice Address - Phone:301-330-4600
Practice Address - Fax:301-330-0558
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-24
Last Update Date:2021-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental