=====================================================
General NPI Number Information
=====================================================
NPI Number | 1548158009
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PARIKH PERIODONTICS PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/25/2025
-----------------------------------------------------
Last Update Date | 06/25/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1075 ROBERTA LN STE 101
-----------------------------------------------------
City | SPARKS
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89431-1893
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 775-799-3468
-----------------------------------------------------
Fax | 775-799-3465
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1075 ROBERTA LN STE 101
-----------------------------------------------------
City | SPARKS
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89431-1893
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 775-799-3468
-----------------------------------------------------
Fax | 775-799-3465
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MANAGER
-----------------------------------------------------
Name | ADAM PARIKH
-----------------------------------------------------
Credential | DMD, MSD
-----------------------------------------------------
Telephone | 775-799-3468
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223P0300X
-----------------------------------------------------
Taxonomy Name | Periodontics
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------