Provider Demographics
NPI:1407471626
Name:SHEA, AARON (DDS)
Entity Type:Individual
Prefix:DR
First Name:AARON
Middle Name:
Last Name:SHEA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 CENTRAL PARK W APT 3W
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-5825
Mailing Address - Country:US
Mailing Address - Phone:917-689-1878
Mailing Address - Fax:
Practice Address - Street 1:220 MADISON AVE STE A
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-3422
Practice Address - Country:US
Practice Address - Phone:212-880-2222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-12
Last Update Date:2022-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0626651223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry