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General NPI Number Information
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NPI Number | 1740502863
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Entity Type | Organization
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Legal Business Name | NIKET SHETH DDS PC
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Dates
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Enumeration Date | 02/16/2010
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Last Update Date | 03/31/2015
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Provider Practice Location Address
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Address Line | 6230 S ASHLAND AVE
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City | CHICAGO
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State | IL
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Zip | 60636-2343
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Country | US
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Telephone | 773-776-1113
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Fax | 773-776-1134
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Provider Business Mailing Address
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Address Line | 6230 S ASHLAND AVE
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City | CHICAGO
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State | IL
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Zip | 60636-2343
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Country | US
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Telephone | 773-776-1113
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Fax | 773-776-1134
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Authorized Official
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Title or Position | OWNER
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Name | DR. NIKET SHETH
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Credential | DDS
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Telephone | 630-270-6829
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 019027089
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License Number State | IL
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