Provider Demographics
NPI:1265058150
Name:KAUSHIK, SHEILA PREETHI (DDS)
Entity type:Individual
Prefix:
First Name:SHEILA
Middle Name:PREETHI
Last Name:KAUSHIK
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13130 PEACH LEAF PL
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-8217
Mailing Address - Country:US
Mailing Address - Phone:571-455-4549
Mailing Address - Fax:
Practice Address - Street 1:4236 82ND ST # C
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-3527
Practice Address - Country:US
Practice Address - Phone:917-396-4700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-17
Last Update Date:2023-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NY0628141223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program