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General NPI Number Information
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NPI Number | 1174907224
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Entity Type | Individual
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Provider Name | REVATHI SHEKAR BDS, MDS
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Gender | Female
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Dates
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Enumeration Date | 07/17/2015
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Last Update Date | 03/24/2023
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Provider Practice Location Address
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Address Line | 3501 TERRACE ST, SALK HALL G120 SALK HALL
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City | PITTSBURGH
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State | PA
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Zip | 15213-2523
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Country | US
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Telephone | 129-095-9415
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Fax |
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Provider Business Mailing Address
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Address Line | 3501 TERRACE ST. G120 SALK HALL
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City | PITTSBURGH
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State | PA
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Zip | 15213-2523
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Country | US
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Telephone | 129-095-9415
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | RFD000056
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 125Q00000X
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Taxonomy Name | Oral Medicine Dentistry
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License Number | RFD000056
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License Number State | PA
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