Provider Demographics
NPI:1598713620
Name:PARIKH, DAKSHA (DDS)
Entity Type:Individual
Prefix:
First Name:DAKSHA
Middle Name:
Last Name:PARIKH
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1007 ACE DR
Mailing Address - Street 2:
Mailing Address - City:BEREA
Mailing Address - State:KY
Mailing Address - Zip Code:40403-1327
Mailing Address - Country:US
Mailing Address - Phone:859-986-5391
Mailing Address - Fax:859-986-3241
Practice Address - Street 1:1007 ACE DRIVE
Practice Address - Street 2:
Practice Address - City:BEREA
Practice Address - State:KY
Practice Address - Zip Code:40403-1015
Practice Address - Country:US
Practice Address - Phone:859-986-5391
Practice Address - Fax:859-986-3241
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2014-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY72241223G0001X, 1223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No1223P0700XDental ProvidersDentistProsthodontics
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100062230Medicaid
KY60072246Medicaid