Healthcare Provider Details

I. General information

NPI: 1306113121
Provider Name (Legal Business Name): TODAY'S FAMILY DENTAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/22/2011
Last Update Date: 11/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1007 ACE DR
BEREA KY
40403-1327
US

IV. Provider business mailing address

1007 ACE DR
BEREA KY
40403-1327
US

V. Phone/Fax

Practice location:
  • Phone: 859-986-5391
  • Fax: 859-986-3241
Mailing address:
  • Phone: 859-986-5391
  • Fax: 859-986-3241

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number7224
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License Number7224
License Number StateKY

VIII. Authorized Official

Name: DR. DAKSHA PARIKH
Title or Position: DENTIST/OWNER
Credential: DDS
Phone: 859-986-5391