Provider Demographics
NPI:1710107982
Name:KESHAV, JAYANTILAL RAMA (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAYANTILAL
Middle Name:RAMA
Last Name:KESHAV
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:JAYANTILAL
Other - Middle Name:R
Other - Last Name:KESHAV
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS INC
Mailing Address - Street 1:8514 PARAMOUNT BLVD
Mailing Address - Street 2:
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90240-2169
Mailing Address - Country:US
Mailing Address - Phone:562-928-5559
Mailing Address - Fax:562-927-6758
Practice Address - Street 1:8514 PARAMOUNT BLVD
Practice Address - Street 2:
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90240-2169
Practice Address - Country:US
Practice Address - Phone:562-928-5559
Practice Address - Fax:562-927-6758
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA31938122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist