Provider Demographics
NPI:1568840775
Name:SHETH, ARCHANA
Entity type:Individual
Prefix:
First Name:ARCHANA
Middle Name:
Last Name:SHETH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ARCHANA
Other - Middle Name:
Other - Last Name:PAREKH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:1325 W BLAINE ST
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92507-3617
Mailing Address - Country:US
Mailing Address - Phone:951-683-1600
Mailing Address - Fax:
Practice Address - Street 1:1325 W BLAINE ST
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92507-3617
Practice Address - Country:US
Practice Address - Phone:951-683-1600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-08
Last Update Date:2021-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA36428122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist