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General NPI Number Information
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NPI Number | 1992226328
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Entity Type | Organization
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Legal Business Name | YASH MEHTA DMD PC
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Dates
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Enumeration Date | 07/06/2017
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Last Update Date | 07/06/2017
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Provider Practice Location Address
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Address Line | 8150 WASHINGTON BLVD #113 SUITE H 1
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City | JESSUP
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State | MD
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Zip | 20794-8808
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Country | US
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Telephone | 240-678-9342
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Fax |
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Provider Business Mailing Address
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Address Line | 8150 WASHINGTON BLVD #113 SUITE H 1
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City | JESSUP
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State | MD
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Zip | 20794-8808
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Country | US
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Telephone | 240-678-9342
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | YASH MEHTA
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Credential | DMD
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Telephone | 240-678-9342
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 14634
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License Number State | MD
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