Provider Demographics
NPI:1538553391
Name:DR. SHANTI, D.C., INC
Entity type:Organization
Organization Name:DR. SHANTI, D.C., INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:SANDEE
Authorized Official - Middle Name:
Authorized Official - Last Name:SHANTI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:808-538-0944
Mailing Address - Street 1:PO BOX 23362
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96823-3362
Mailing Address - Country:US
Mailing Address - Phone:808-538-0944
Mailing Address - Fax:
Practice Address - Street 1:1066A GREEN STREET, #3
Practice Address - Street 2:
Practice Address - City:HONOLUU
Practice Address - State:HI
Practice Address - Zip Code:96822
Practice Address - Country:US
Practice Address - Phone:808-538-0944
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-19
Last Update Date:2015-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1067111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty