Provider Demographics
NPI:1881211654
Name:GOHIL, VEDANT CHIMANLAL (DDS)
Entity Type:Individual
Prefix:
First Name:VEDANT
Middle Name:CHIMANLAL
Last Name:GOHIL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1304 JUNCTION HWY STE 750
Mailing Address - Street 2:
Mailing Address - City:KERRVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78028-4864
Mailing Address - Country:US
Mailing Address - Phone:830-895-3889
Mailing Address - Fax:
Practice Address - Street 1:1304 JUNCTION HWY STE 750
Practice Address - Street 2:
Practice Address - City:KERRVILLE
Practice Address - State:TX
Practice Address - Zip Code:78028-4864
Practice Address - Country:US
Practice Address - Phone:830-895-3889
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-28
Last Update Date:2020-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX36227122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty