Healthcare Provider Details

I. General information

NPI: 1780329573
Provider Name (Legal Business Name): SWETA SHETH DDS PROSPER PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2022
Last Update Date: 08/11/2022
Certification Date: 08/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1061 N COLEMAN ST STE 60
PROSPER TX
75078-2317
US

IV. Provider business mailing address

2617 WALES WAY
LEWISVILLE TX
75056-5911
US

V. Phone/Fax

Practice location:
  • Phone: 469-425-8555
  • Fax: 469-425-8222
Mailing address:
  • Phone: 972-835-9254
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SWETA SHETH
Title or Position: DENTIST OWNER
Credential: DDS
Phone: 972-835-9254