Provider Demographics
NPI:1962491639
Name:BURTON, SHEVA TERESA (DDS)
Entity Type:Individual
Prefix:DR
First Name:SHEVA
Middle Name:TERESA
Last Name:BURTON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:SHEVA
Other - Middle Name:TERESA
Other - Last Name:NICKRAVESH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:P.O. BOX 3263
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33509
Mailing Address - Country:US
Mailing Address - Phone:530-782-3367
Mailing Address - Fax:
Practice Address - Street 1:5456 SPRING HILL DRIVE
Practice Address - Street 2:PALM TREE DENTISTRY
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34606
Practice Address - Country:US
Practice Address - Phone:352-666-1400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-17
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA516291223P0221X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No122300000XDental ProvidersDentist