Provider Demographics
NPI:1902034523
Name:SHAH, SWETA (DDS)
Entity Type:Individual
Prefix:DR
First Name:SWETA
Middle Name:
Last Name:SHAH
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:SWETA
Other - Middle Name:
Other - Last Name:SHETH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2617 WALES WAY
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75056-5911
Mailing Address - Country:US
Mailing Address - Phone:972-835-9254
Mailing Address - Fax:
Practice Address - Street 1:2617 WALES WAY
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75056-5911
Practice Address - Country:US
Practice Address - Phone:972-835-9254
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-23
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX24737122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX24737OtherLICENSE