Provider Demographics
NPI:1912631938
Name:AL SHALTONI, NOOR (DDS)
Entity type:Individual
Prefix:
First Name:NOOR
Middle Name:
Last Name:AL SHALTONI
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 1:2101 SPOONBILL DR
Mailing Address - Street 2:
Mailing Address - City:WEST LAFAYETTE
Mailing Address - State:IN
Mailing Address - Zip Code:47906-6704
Mailing Address - Country:US
Mailing Address - Phone:832-621-1998
Mailing Address - Fax:
Practice Address - Street 1:13760 LAKERIDGE DR
Practice Address - Street 2:
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46037-7608
Practice Address - Country:US
Practice Address - Phone:317-588-2575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-14
Last Update Date:2025-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADF1000441223P0221X
390200000X
IN12014657A1223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program