Provider Demographics
NPI:1154843563
Name:SETHI, NTASHA (DMD, MDS, BDS)
Entity Type:Individual
Prefix:
First Name:NTASHA
Middle Name:
Last Name:SETHI
Suffix:
Gender:F
Credentials:DMD, MDS, BDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15841 SAINT CLAIR AVE
Mailing Address - Street 2:
Mailing Address - City:EAST LIVERPOOL
Mailing Address - State:OH
Mailing Address - Zip Code:43920-9141
Mailing Address - Country:US
Mailing Address - Phone:330-385-6201
Mailing Address - Fax:
Practice Address - Street 1:15841 SAINT CLAIR AVE
Practice Address - Street 2:
Practice Address - City:EAST LIVERPOOL
Practice Address - State:OH
Practice Address - Zip Code:43920-9141
Practice Address - Country:US
Practice Address - Phone:330-385-6201
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-07
Last Update Date:2020-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS041388122300000X
OH30025572122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0316179Medicaid