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General NPI Number Information
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NPI Number | 1023961752
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Entity Type | Individual
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Provider Name | DR. SIDHARRTH MEHTA
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Gender | Male
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Dates
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Enumeration Date | 02/20/2026
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Last Update Date | 02/20/2026
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Provider Practice Location Address
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Address Line | 7222 FOREST BROOK DR
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City | SYLVANIA
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State | OH
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Zip | 43560-2800
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Country | US
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Telephone | 567-801-0080
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Fax |
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Provider Business Mailing Address
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Address Line | 7222 FOREST BROOK DR
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City | SYLVANIA
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State | OH
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Zip | 43560-2800
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Country | US
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Telephone | 567-801-0080
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DE70070746
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License Number State | WA
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