Provider Demographics
NPI:1821187139
Name:SHETH, JITEN (BDS,MS)
Entity Type:Individual
Prefix:DR
First Name:JITEN
Middle Name:
Last Name:SHETH
Suffix:
Gender:M
Credentials:BDS,MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 LEXINGTON GREEN LN
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32771-1023
Mailing Address - Country:US
Mailing Address - Phone:407-878-5888
Mailing Address - Fax:
Practice Address - Street 1:320 LEXINGTON GREEN LN
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:FL
Practice Address - Zip Code:32771-1023
Practice Address - Country:US
Practice Address - Phone:407-878-5888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2010-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN11877122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist