Provider Demographics
NPI:1326217878
Name:SHETH, KARISHMA (DDS)
Entity Type:Individual
Prefix:DR
First Name:KARISHMA
Middle Name:
Last Name:SHETH
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 1:201 50TH AVE
Mailing Address - Street 2:APT P4C
Mailing Address - City:LONG ISLAND CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11101-5739
Mailing Address - Country:US
Mailing Address - Phone:415-336-7178
Mailing Address - Fax:
Practice Address - Street 1:201 50TH AVE
Practice Address - Street 2:APT P4C
Practice Address - City:LONG ISLAND CITY
Practice Address - State:NY
Practice Address - Zip Code:11101-5739
Practice Address - Country:US
Practice Address - Phone:415-336-7178
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-28
Last Update Date:2009-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX233191223G0001X
NY0546621223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX23319OtherLICENSE
NY054662OtherNYS