Provider Demographics
NPI:1710137229
Name:MEHTA, SALIL (DMD)
Entity Type:Individual
Prefix:DR
First Name:SALIL
Middle Name:
Last Name:MEHTA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:810 LAKE CAROLYN PKWY
Mailing Address - Street 2:#410
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75039-4168
Mailing Address - Country:US
Mailing Address - Phone:248-390-5063
Mailing Address - Fax:
Practice Address - Street 1:45 WALL ST
Practice Address - Street 2:APT. 1712
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10005-1918
Practice Address - Country:US
Practice Address - Phone:248-390-5063
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-22
Last Update Date:2010-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX243261223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice