Provider Demographics
NPI:1215025879
Name:MEHTA, HARHSA D (DDS)
Entity Type:Individual
Prefix:DR
First Name:HARHSA
Middle Name:D
Last Name:MEHTA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 06A SUTPHIN BOULEVARD
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11435-3636
Mailing Address - Country:US
Mailing Address - Phone:718-526-7049
Mailing Address - Fax:718-526-2722
Practice Address - Street 1:90-06A SUTPHIN BOULEVARD
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11435-3636
Practice Address - Country:US
Practice Address - Phone:718-526-7049
Practice Address - Fax:718-526-2722
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0369171223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY766550Medicaid