Provider Demographics
NPI:1457037293
Name:SHRESTHA, RUASHA (DMD)
Entity Type:Individual
Prefix:
First Name:RUASHA
Middle Name:
Last Name:SHRESTHA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12328 HULSON TRL
Mailing Address - Street 2:
Mailing Address - City:HASLET
Mailing Address - State:TX
Mailing Address - Zip Code:76052-1614
Mailing Address - Country:US
Mailing Address - Phone:682-408-8784
Mailing Address - Fax:
Practice Address - Street 1:12328 HULSON TRL
Practice Address - Street 2:
Practice Address - City:HASLET
Practice Address - State:TX
Practice Address - Zip Code:76052-1614
Practice Address - Country:US
Practice Address - Phone:682-408-8784
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-26
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX39673122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist