Healthcare Provider Details

I. General information

NPI: 1912565284
Provider Name (Legal Business Name): ANIRUDDHA CHINTAN PARIKH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2019
Last Update Date: 10/09/2025
Certification Date: 10/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5320 S RAINBOW BLVD STE 250
LAS VEGAS NV
89118-1807
US

IV. Provider business mailing address

3016 W CHARLESTON BLVD STE 100
LAS VEGAS NV
89102-1973
US

V. Phone/Fax

Practice location:
  • Phone: 702-671-6480
  • Fax: 702-671-6481
Mailing address:
  • Phone: 702-780-2315
  • Fax: 702-895-4014

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number390200000X
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code207YX0007X
TaxonomyPlastic Surgery within the Head & Neck (Otolaryngology) Physician
License Number28148
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: