Healthcare Provider Details

I. General information

NPI: 1952813305
Provider Name (Legal Business Name): MAHANT DENTAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2017
Last Update Date: 05/16/2024
Certification Date: 05/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3989 N BELT LINE RD
IRVING TX
75038-5706
US

IV. Provider business mailing address

3989 N BELT LINE RD
IRVING TX
75038-5706
US

V. Phone/Fax

Practice location:
  • Phone: 972-261-1166
  • Fax: 972-433-6475
Mailing address:
  • Phone: 972-261-1166
  • Fax: 972-261-1166

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number27383
License Number StateTX

VIII. Authorized Official

Name: MEGHA L PATEL
Title or Position: OWNER DENTIST
Credential: DDS
Phone: 313-399-9078