MEDICARE: DEPAL PARIKH DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	24956	TX

General Provider Information

NPI Number	:	1396078416
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEPAL PARIKH DDS

Provider Business Mailing Address
First Line	:	8216 MALABAR TRL
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76123-4625
Country	:	US
Telephone Number	:	443-841-4772
Fax Number	:

Provider Business Practice Location Address
First Line	:	2417 PARK HILL DR # 119
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76110-2240
Country	:	US
Telephone Number	:	817-926-9771
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/08/2009
Last Update Date	:	09/08/2009

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