Provider Demographics
NPI:1275013583
Name:SHRESTHA, POOJAN
Entity Type:Individual
Prefix:
First Name:POOJAN
Middle Name:
Last Name:SHRESTHA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 DENTAL CIR STE 143
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27599-0001
Mailing Address - Country:US
Mailing Address - Phone:919-537-3771
Mailing Address - Fax:919-537-3950
Practice Address - Street 1:140 DENTAL CIR STE 143
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27599-0001
Practice Address - Country:US
Practice Address - Phone:919-537-3956
Practice Address - Fax:919-537-3950
Is Sole Proprietor?:No
Enumeration Date:2018-08-16
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC02611223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry