Provider Demographics
NPI:1083338719
Name:PAREKH, MAITRY (DMD)
Entity Type:Individual
Prefix:DR
First Name:MAITRY
Middle Name:
Last Name:PAREKH
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:275 RIDGE RD APT 307
Mailing Address - Street 2:
Mailing Address - City:WETHERSFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06109-1552
Mailing Address - Country:US
Mailing Address - Phone:978-954-4578
Mailing Address - Fax:
Practice Address - Street 1:146 HIGHLAND AVE STE 1
Practice Address - Street 2:
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06708-2761
Practice Address - Country:US
Practice Address - Phone:203-527-4614
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-27
Last Update Date:2022-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT13574122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist