Provider Demographics
NPI:1932496668
Name:DOSHI, JAYA G (DMD)
Entity Type:Individual
Prefix:
First Name:JAYA
Middle Name:G
Last Name:DOSHI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3680 STATE HIGHWAY 121 STE 100
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75025-5204
Mailing Address - Country:US
Mailing Address - Phone:617-794-5879
Mailing Address - Fax:
Practice Address - Street 1:3680 STATE HIGHWAY 121 STE 100
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75025-5204
Practice Address - Country:US
Practice Address - Phone:617-794-5879
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-01
Last Update Date:2020-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN18557621223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice