MEDICARE: DR. BHAVIKKUMAR TRIVEDI BDS, MPH

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	126800000X	Dental Assistant	136978	TX
2	390200000X	Student in an Organized Health Care Education/Training Program		AZ
3	126800000X	Dental Assistant		GA

General Provider Information

NPI Number	:	1497571061
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BHAVIKKUMAR TRIVEDI BDS, MPH

Provider Business Mailing Address
First Line	:	332 ARDSLEY PL
Second Line	:
City	:	NORCROSS
State	:	GA
Zip	:	30093-5208
Country	:	US
Telephone Number	:	346-542-0384
Fax Number	:

Provider Business Practice Location Address
First Line	:	707 WHITLOCK AVE SW STE C25
Second Line	:
City	:	MARIETTA
State	:	GA
Zip	:	30064-4655
Country	:	US
Telephone Number	:	770-282-5061
Fax Number	:

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

Provider Enumeration Date	:	11/28/2024
Last Update Date	:	12/04/2025

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