MEDICARE: DR. JAANAVI PARESH DEDHIA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	38435	TX

General Provider Information

NPI Number	:	1588393920
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAANAVI PARESH DEDHIA

Provider Business Mailing Address
First Line	:	3030 LBJ FWY STE 1700 (HEAD OFFICE)
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75234-2759
Country	:	US
Telephone Number	:	972-444-8888
Fax Number	:

Provider Business Practice Location Address
First Line	:	529 SW MILITARY DR
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78221-1636
Country	:	US
Telephone Number	:	210-547-7191
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/09/2022
Last Update Date	:	05/05/2026

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