Provider Demographics
NPI:1598171225
Name:PAREKH, NIRAV (DDS MHA)
Entity Type:Individual
Prefix:
First Name:NIRAV
Middle Name:
Last Name:PAREKH
Suffix:
Gender:M
Credentials:DDS MHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 TOWNE ST APT 225
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06902-5971
Mailing Address - Country:US
Mailing Address - Phone:941-920-1374
Mailing Address - Fax:
Practice Address - Street 1:835 WOLCOTT ST
Practice Address - Street 2:
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06705-1315
Practice Address - Country:US
Practice Address - Phone:203-596-1960
Practice Address - Fax:203-596-1998
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-02
Last Update Date:2014-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT11215122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist