Provider Demographics
NPI:1013776665
Name:MEHTA, PAAVAN V (DMD)
Entity Type:Individual
Prefix:DR
First Name:PAAVAN
Middle Name:V
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 1:4 EDNA PL
Mailing Address - Street 2:
Mailing Address - City:PISCATAWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08854-3314
Mailing Address - Country:US
Mailing Address - Phone:732-910-5953
Mailing Address - Fax:
Practice Address - Street 1:4 EDNA PL
Practice Address - Street 2:
Practice Address - City:PISCATAWAY
Practice Address - State:NJ
Practice Address - Zip Code:08854-3314
Practice Address - Country:US
Practice Address - Phone:732-910-5953
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-18
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI03016800122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist