Provider Demographics
NPI:1609125897
Name:SETHI, SHAVETA (BDS, MDS)
Entity Type:Individual
Prefix:DR
First Name:SHAVETA
Middle Name:
Last Name:SETHI
Suffix:
Gender:F
Credentials:BDS, MDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4144 N CENTRAL EXPY
Mailing Address - Street 2:SUITE 905
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75204-3140
Mailing Address - Country:US
Mailing Address - Phone:214-826-2364
Mailing Address - Fax:214-826-2331
Practice Address - Street 1:4144 N CENTRAL EXPY
Practice Address - Street 2:SUITE 905
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75204-3140
Practice Address - Country:US
Practice Address - Phone:214-826-2364
Practice Address - Fax:214-826-2331
Is Sole Proprietor?:No
Enumeration Date:2012-09-03
Last Update Date:2015-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX283601223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics