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General NPI Number Information
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NPI Number | 1417193897
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Entity Type | Individual
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Provider Name | PARUL JAIN D.D.S
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Gender | Female
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Dates
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Enumeration Date | 01/06/2009
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Last Update Date | 10/28/2021
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Provider Practice Location Address
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Address Line | 1425 ELLSWORTH INDUSTRIAL BLVD NW STE 36
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City | ATLANTA
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State | GA
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Zip | 30318-4154
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Country | US
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Telephone | 404-777-7147
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Fax | 404-777-7147
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Provider Business Mailing Address
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Address Line | 1425 ELLSWORTH INDUSTRIAL BLVD NW STE 36
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City | ATLANTA
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State | GA
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Zip | 30318-4154
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Country | US
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Telephone | 404-777-7147
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Fax | 404-777-7147
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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 | DN614709
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 054076
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 014709
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License Number State | GA
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