Healthcare Provider Details

I. General information

NPI: 1417692476
Provider Name (Legal Business Name): ANKITA SHETH DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2022
Last Update Date: 01/12/2026
Certification Date: 01/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6132 CAROLINA BEACH RD STE 8
WILMINGTON NC
28412-2759
US

IV. Provider business mailing address

161 DUGGER LN
WILMINGTON NC
28412-3685
US

V. Phone/Fax

Practice location:
  • Phone: 423-693-7244
  • Fax:
Mailing address:
  • Phone: 423-693-7244
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number14550
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN122317
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN122317
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: