Healthcare Provider Details

I. General information

NPI: 1629381363
Provider Name (Legal Business Name): DHARMESH MEHTA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2010
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6555 WILSON MILLS RD STE 103D
MAYFIELD VILLAGE OH
44143-3435
US

IV. Provider business mailing address

PO BOX 931596
CLEVELAND OH
44193-1724
US

V. Phone/Fax

Practice location:
  • Phone: 440-946-8300
  • Fax: 440-946-8327
Mailing address:
  • Phone: 440-946-8300
  • Fax: 440-946-8327

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35121792
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: