Provider Demographics
NPI:1194893917
Name:SETHI, SANGEETA
Entity type:Individual
Prefix:
First Name:SANGEETA
Middle Name:
Last Name:SETHI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1022 E 163 ST
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10459
Mailing Address - Country:US
Mailing Address - Phone:718-542-2088
Mailing Address - Fax:718-542-2053
Practice Address - Street 1:1022 E 163 ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10459
Practice Address - Country:US
Practice Address - Phone:718-542-2088
Practice Address - Fax:718-542-2053
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2017-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT088581223P0221X, 1223X0400X
FL157731223P0221X, 1223X0400X
NY04405111223P0221X, 1223X0400X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
No1223G0001XDental ProvidersDentistGeneral Practice