Healthcare Provider Details

I. General information

NPI: 1295573210
Provider Name (Legal Business Name): BHRITA PARIKH DMD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2024
Last Update Date: 01/10/2025
Certification Date: 01/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8488 CHARLOTTE HWY SUIT 101
INDIAN LAND SC
29707-7587
US

IV. Provider business mailing address

11507 GLANMIRE DR
MATTHEWS NC
28105-0068
US

V. Phone/Fax

Practice location:
  • Phone: 213-590-2049
  • Fax: 839-400-2196
Mailing address:
  • Phone: 213-590-2049
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD1600X
TaxonomyDevelopmental Disabilities Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: BHRITA H PARIKH
Title or Position: OWNER DENTIST
Credential: DMD
Phone: 213-590-2049