Provider Demographics
NPI:1093927386
Name:MATHUR, AESHNA (DMD)
Entity Type:Individual
Prefix:
First Name:AESHNA
Middle Name:
Last Name:MATHUR
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:AESHNA
Other - Middle Name:
Other - Last Name:SHARMA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:9193 SIERRA AVE
Mailing Address - Street 2:STE D
Mailing Address - City:FONTANA
Mailing Address - State:CA
Mailing Address - Zip Code:92335-4776
Mailing Address - Country:US
Mailing Address - Phone:909-822-2227
Mailing Address - Fax:
Practice Address - Street 1:220 E BEVERLY BLVD
Practice Address - Street 2:
Practice Address - City:MONTEBELLO
Practice Address - State:CA
Practice Address - Zip Code:90640-3722
Practice Address - Country:US
Practice Address - Phone:323-888-1192
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2016-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA525431223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics