Provider Demographics
NPI:1821105099
Name:GADHIA, MEHUL H (DMD, MSP)
Entity Type:Individual
Prefix:DR
First Name:MEHUL
Middle Name:H
Last Name:GADHIA
Suffix:
Gender:M
Credentials:DMD, MSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14135 BALLANTYNE CORPORATE PL
Mailing Address - Street 2:SUITE 175
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277-3383
Mailing Address - Country:US
Mailing Address - Phone:704-541-8090
Mailing Address - Fax:704-541-6712
Practice Address - Street 1:14135 BALLANTYNE CORPORATE PL
Practice Address - Street 2:SUITE 175
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277-3383
Practice Address - Country:US
Practice Address - Phone:704-541-8090
Practice Address - Fax:704-541-6712
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2019-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC77061223P0300X
FLDN164841223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics