Provider Demographics
NPI:1639859234
Name:SHERPA, TSERING CHULTIM (DMD)
Entity Type:Individual
Prefix:DR
First Name:TSERING
Middle Name:CHULTIM
Last Name:SHERPA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4247 LOCUST ST APT 414
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-5264
Mailing Address - Country:US
Mailing Address - Phone:206-790-1408
Mailing Address - Fax:
Practice Address - Street 1:600 GETTY AVE
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07011-2161
Practice Address - Country:US
Practice Address - Phone:973-594-6931
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-19
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI029748001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice