Provider Demographics
NPI:1326430737
Name:PAREKH, PARTH (DDS)
Entity Type:Individual
Prefix:
First Name:PARTH
Middle Name:
Last Name:PAREKH
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 1:104 4TH STREET
Mailing Address - Street 2:
Mailing Address - City:BLADENBORO
Mailing Address - State:NC
Mailing Address - Zip Code:28320
Mailing Address - Country:US
Mailing Address - Phone:910-863-2377
Mailing Address - Fax:910-863-2555
Practice Address - Street 1:104 4TH STREET
Practice Address - Street 2:
Practice Address - City:BLADENBORO
Practice Address - State:NC
Practice Address - Zip Code:28320
Practice Address - Country:US
Practice Address - Phone:910-863-2377
Practice Address - Fax:910-863-2555
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-22
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC88211223G0001X
390200000X
NC106001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
FB6337263OtherDEA