Healthcare Provider Details

I. General information

NPI: 1962491639
Provider Name (Legal Business Name): SHEVA TERESA BURTON D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SHEVA TERESA NICKRAVESH D.D.S.

II. Dates (important events)

Enumeration Date: 10/17/2005
Last Update Date: 03/25/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5456 SPRING HILL DRIVE PALM TREE DENTISTRY
SPRING HILL FL
34606
US

IV. Provider business mailing address

P.O. BOX 3263
BRANDON FL
33509
US

V. Phone/Fax

Practice location:
  • Phone: 352-666-1400
  • Fax:
Mailing address:
  • Phone: 530-782-3367
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number51629
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License NumberD27735
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: