Provider Demographics
NPI:1174907224
Name:SHEKAR, REVATHI (BDS, MDS)
Entity type:Individual
Prefix:
First Name:REVATHI
Middle Name:
Last Name:SHEKAR
Suffix:
Gender:F
Credentials:BDS, MDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3501 TERRACE ST.
Mailing Address - Street 2:G120 SALK HALL
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213-2523
Mailing Address - Country:US
Mailing Address - Phone:129-095-9415
Mailing Address - Fax:
Practice Address - Street 1:3501 TERRACE ST, SALK HALL
Practice Address - Street 2:G120 SALK HALL
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-2523
Practice Address - Country:US
Practice Address - Phone:129-095-9415
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-17
Last Update Date:2023-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARFD000056122300000X, 125Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes125Q00000XDental ProvidersDentistOral Medicine
No122300000XDental ProvidersDentist