Provider Demographics
NPI:1255486700
Name:MEHTA, NIRAV (DDS)
Entity Type:Individual
Prefix:DR
First Name:NIRAV
Middle Name:
Last Name:MEHTA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:895 E FREMONT AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94087-2982
Mailing Address - Country:US
Mailing Address - Phone:408-732-0220
Mailing Address - Fax:
Practice Address - Street 1:895 E FREMONT AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94087-2982
Practice Address - Country:US
Practice Address - Phone:408-732-0220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2007-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA483321223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice