Provider Demographics
NPI:1316226988
Name:ADESHARA, KARISHMA (DMD)
Entity Type:Individual
Prefix:
First Name:KARISHMA
Middle Name:
Last Name:ADESHARA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:327 W SUNSET RD APT 2235
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78209-1750
Mailing Address - Country:US
Mailing Address - Phone:201-286-0899
Mailing Address - Fax:
Practice Address - Street 1:7334 SAN PEDRO AVE
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78216-6224
Practice Address - Country:US
Practice Address - Phone:210-625-4724
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX317191223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice