Provider Demographics
NPI:1053522797
Name:PAREEK, SHIVANI (DMD)
Entity type:Individual
Prefix:DR
First Name:SHIVANI
Middle Name:
Last Name:PAREEK
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 HANOVER ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02113-2300
Mailing Address - Country:US
Mailing Address - Phone:617-523-7860
Mailing Address - Fax:
Practice Address - Street 1:215 HANOVER ST
Practice Address - Street 2:SUITE 2
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02113-2300
Practice Address - Country:US
Practice Address - Phone:617-523-7860
Practice Address - Fax:617-720-4394
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAMA20639122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAMASSHEALTH IDOther0298191