Provider Demographics
NPI:1821544073
Name:KOSHY, MERLIN PRASHANT (DDS)
Entity Type:Individual
Prefix:
First Name:MERLIN
Middle Name:PRASHANT
Last Name:KOSHY
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 1:2524 CROOKED CREEK
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75181-9531
Mailing Address - Country:US
Mailing Address - Phone:916-878-9481
Mailing Address - Fax:
Practice Address - Street 1:2000 ESTERS RD
Practice Address - Street 2:SUITE#100
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75061-9531
Practice Address - Country:US
Practice Address - Phone:972-871-9800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-28
Last Update Date:2016-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX323251223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice