Healthcare Provider Details

I. General information

NPI: 1245608546
Provider Name (Legal Business Name): BHAVIN TRIVEDI DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/03/2015
Last Update Date: 08/26/2025
Certification Date: 08/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

NAVAL HOSPITAL JACKSONVILLE 2080 CHILD STREET
JACKSONVILLE FL
32214-0001
US

IV. Provider business mailing address

NAVAL HOSPITAL JACKSONVILLE 2080 CHILD STREET
JACKSONVILLE FL
32214-0001
US

V. Phone/Fax

Practice location:
  • Phone: 904-542-7300
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number32814
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number0401417810
License Number StateVA
# 3
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License NumberDN30921
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: