Provider Demographics
NPI:1467414730
Name:PARIKH, PURVAK VIJAY (DDS)
Entity Type:Individual
Prefix:
First Name:PURVAK
Middle Name:VIJAY
Last Name:PARIKH
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 1:125 ASCOT DR
Mailing Address - Street 2:SUITE D
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-3408
Mailing Address - Country:US
Mailing Address - Phone:916-782-3129
Mailing Address - Fax:
Practice Address - Street 1:125 ASCOT DR
Practice Address - Street 2:SUITE D
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-3408
Practice Address - Country:US
Practice Address - Phone:916-782-3129
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-04
Last Update Date:2008-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA49628122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
D49628Medicare ID - Type Unspecified