=====================================================
General NPI Number Information
=====================================================
NPI Number | 1093896128
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | D.R.MERCHANT, LTD.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/17/2006
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2525 S. RURAL ROAD, STE.2N
-----------------------------------------------------
City | TEMPE
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85282-2441
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 480-966-9936
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2525 S. RURAL ROAD, STE.2N
-----------------------------------------------------
City | TEMPE
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85282-2441
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 480-966-9936
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DHANLAXMI R MERCHANT
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 480-966-9936
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223G0001X
-----------------------------------------------------
Taxonomy Name | General Practice Dentistry
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------