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General NPI Number Information
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NPI Number | 1407699945
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Entity Type | Individual
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Provider Name | JAY TRIVEDI DDS
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Gender | Male
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Dates
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Enumeration Date | 06/13/2024
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Last Update Date | 02/04/2026
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Provider Practice Location Address
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Address Line | 616 GAYLE ST STE NO100
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City | GARDENDALE
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State | AL
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Zip | 35071-3055
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Country | US
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Telephone | 205-273-8552
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Fax |
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Provider Business Mailing Address
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Address Line | 7233 COTTONWOOD DR
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City | SHAWNEE
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State | KS
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Zip | 66216-3785
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Country | US
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Telephone | 913-808-7913
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 2024044394
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 62129
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License Number State | KS
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