Provider Demographics
NPI:1174970230
Name:SHETH, MILAN (DDS)
Entity type:Individual
Prefix:
First Name:MILAN
Middle Name:
Last Name:SHETH
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3206 EL LAGO NORTH DR
Mailing Address - Street 2:APT B
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46227-4022
Mailing Address - Country:US
Mailing Address - Phone:219-487-1164
Mailing Address - Fax:
Practice Address - Street 1:4350 N FRANKLIN RD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46226-4002
Practice Address - Country:US
Practice Address - Phone:317-546-5305
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-18
Last Update Date:2016-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12012485A1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice