Provider Demographics
NPI:1053470005
Name:PAREKH, SANJAY (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:SANJAY
Middle Name:
Last Name:PAREKH
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:DR
Other - First Name:JAY
Other - Middle Name:
Other - Last Name:PAREKH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS MS
Mailing Address - Street 1:5526 WINDING CAPE WAY
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:OH
Mailing Address - Zip Code:45040-5017
Mailing Address - Country:US
Mailing Address - Phone:513-335-2342
Mailing Address - Fax:
Practice Address - Street 1:1937 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:KY
Practice Address - Zip Code:41101-7747
Practice Address - Country:US
Practice Address - Phone:606-329-0038
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-06
Last Update Date:2013-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.0220561223X0400X
KY84341223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics