Provider Demographics
NPI:1568871051
Name:MEHTA, AKHIL (DDS)
Entity Type:Individual
Prefix:
First Name:AKHIL
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 1:6092 E PASEO CIMARRON
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85750-1111
Mailing Address - Country:US
Mailing Address - Phone:501-269-3044
Mailing Address - Fax:
Practice Address - Street 1:350 E BELL RD
Practice Address - Street 2:SUITE 211
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85022-6311
Practice Address - Country:US
Practice Address - Phone:602-375-1517
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-08
Last Update Date:2015-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD009056122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist