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General NPI Number Information
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NPI Number | 1548552169
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Entity Type | Individual
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Provider Name | NIYATI SHETH DDS
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Gender | Female
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Dates
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Enumeration Date | 05/15/2011
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Last Update Date | 05/15/2011
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Provider Practice Location Address
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Address Line | 613 MORRIS AVE
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City | SPRINGFIELD
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State | NJ
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Zip | 07081-1511
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Country | US
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Telephone | 973-572-7097
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Fax |
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Provider Business Mailing Address
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Address Line | 24 RIVER RD APT 5
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City | CLIFTON
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State | NJ
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Zip | 07014-2017
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Country | US
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Telephone | 973-572-7097
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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 | 22DI02453600
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DS038598
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License Number State | PA
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