MEDICARE: DR. KARISHMA SITAPARA DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	DS041911	PA
2	390200000X	Student in an Organized Health Care Education/Training Program
3	1223G0001X	General Practice Dentistry	13344925-9922	UT

General Provider Information

NPI Number	:	1083142467
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KARISHMA SITAPARA DDS

Provider Business Mailing Address
First Line	:	6784 MARKET ST
Second Line	:
City	:	UPPER DARBY
State	:	PA
Zip	:	19082-2431
Country	:	US
Telephone Number	:	484-462-0171
Fax Number	:

Provider Business Practice Location Address
First Line	:	2114 S HIGHLAND DR
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84106-2807
Country	:	US
Telephone Number	:	801-467-2345
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/30/2017
Last Update Date	:	07/24/2023

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