Provider Demographics
NPI:1568668945
Name:TRIVEDI, AMEET YOGESH (DDS)
Entity Type:Individual
Prefix:MR
First Name:AMEET
Middle Name:YOGESH
Last Name:TRIVEDI
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 1:500 E BEN WHITE BLVD
Mailing Address - Street 2:D-400
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78704-7470
Mailing Address - Country:US
Mailing Address - Phone:512-968-7857
Mailing Address - Fax:512-350-2866
Practice Address - Street 1:500 E BEN WHITE BLVD
Practice Address - Street 2:D-400
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-7470
Practice Address - Country:US
Practice Address - Phone:512-968-7857
Practice Address - Fax:512-350-2866
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-22
Last Update Date:2014-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX261831223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice