Provider Demographics
NPI:1366658320
Name:MEHTA, BEHRAMJI J (BDS)
Entity Type:Individual
Prefix:DR
First Name:BEHRAMJI
Middle Name:J
Last Name:MEHTA
Suffix:
Gender:M
Credentials:BDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15207 SOUTHWEST FWY
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-3872
Mailing Address - Country:US
Mailing Address - Phone:281-980-0101
Mailing Address - Fax:281-980-8155
Practice Address - Street 1:15207 SOUTHWEST FWY
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-3872
Practice Address - Country:US
Practice Address - Phone:281-980-0101
Practice Address - Fax:281-980-8155
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX179901223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice