MEDICARE: DR. ROSHNI PARAG 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	122300000X	Dentist	9848	KY

General Provider Information

NPI Number	:	1972058626
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROSHNI PARAG PARIKH DDS

Provider Business Mailing Address
First Line	:	200 S HAMPTON PL
Second Line	:	APT 6-207
City	:	CLARKSVILLE
State	:	TN
Zip	:	37040-6359
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4131 FORT CAMPBELL BLVD
Second Line	:
City	:	HOPKINSVILLE
State	:	KY
Zip	:	42240-8706
Country	:	US
Telephone Number	:	270-632-4342
Fax Number	:

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

Provider Enumeration Date	:	08/23/2016
Last Update Date	:	08/23/2016

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