Provider Demographics
NPI:1548552169
Name:SHETH, NIYATI (DDS)
Entity type:Individual
Prefix:DR
First Name:NIYATI
Middle Name:
Last Name:SHETH
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 RIVER RD APT 5
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07014-2017
Mailing Address - Country:US
Mailing Address - Phone:973-572-7097
Mailing Address - Fax:
Practice Address - Street 1:613 MORRIS AVE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07081-1511
Practice Address - Country:US
Practice Address - Phone:973-572-7097
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-15
Last Update Date:2011-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI02453600122300000X
PADS038598122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist