Provider Demographics
NPI:1184195885
Name:MEGHA JADHAV DMD, INC
Entity Type:Organization
Organization Name:MEGHA JADHAV DMD, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MEGHA
Authorized Official - Middle Name:R
Authorized Official - Last Name:JADHAV
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:707-427-3111
Mailing Address - Street 1:1261 TRAVIS BLVD STE 160
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94533-4807
Mailing Address - Country:US
Mailing Address - Phone:707-427-3111
Mailing Address - Fax:707-427-3893
Practice Address - Street 1:MEGHA JADHAV DMD INC
Practice Address - Street 2:1261 TRAVIS BLVD STE 160
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94533-3642
Practice Address - Country:US
Practice Address - Phone:707-427-3111
Practice Address - Fax:707-427-3893
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-06
Last Update Date:2020-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental