Provider Demographics
NPI:1437572005
Name:LYTTLE, SHRADHA (DDS)
Entity Type:Individual
Prefix:DR
First Name:SHRADHA
Middle Name:
Last Name:LYTTLE
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 1:2430 S INTERSTATE 35 E STE 210
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76205-4944
Mailing Address - Country:US
Mailing Address - Phone:402-452-8315
Mailing Address - Fax:
Practice Address - Street 1:2430 S INTERSTATE 35 E # SOUTH
Practice Address - Street 2:SUITE 210
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76205-4986
Practice Address - Country:US
Practice Address - Phone:940-387-2214
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-01
Last Update Date:2020-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX29077122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist