Individual
DR. SHERNA SHETH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS, MD
Contact information
Practice address
1020 TIJERAS AVE NE STE 22, ALBUQUERQUE, NM 87106-4749
(505) 727-1670
Mailing address
MSC 10-5610 1 UNIVERSITY OF NEW MEXICO, ALBUQUERQUE, NM 87131-0001
(505) 272-6451
(505) 925-4310
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
0401414163
VA
207Y00000X
Otolaryngology Physician
Primary
MD2024-1148
NM
390200000X
Student in an Organized Health Care Education/Training Program
—
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0401414163
VIRGINIA BOARD OF DENTISTRY
VA
01
—
MD2024-1148
NEW MEXICO LICENSE
NM
Enumeration date
05/20/2014
Last updated
11/18/2024
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