Provider Demographics
NPI:1497571061
Name:TRIVEDI, BHAVIKKUMAR (BDS, MPH, RDA)
Entity type:Individual
Prefix:DR
First Name:BHAVIKKUMAR
Middle Name:
Last Name:TRIVEDI
Suffix:
Gender:M
Credentials:BDS, MPH, RDA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1907 HARVARD DR
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75081-3155
Mailing Address - Country:US
Mailing Address - Phone:346-542-0384
Mailing Address - Fax:
Practice Address - Street 1:347 W JEFFERSON BLVD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75208-4602
Practice Address - Country:US
Practice Address - Phone:972-290-0903
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-28
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX136978126800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes126800000XDental ProvidersDental Assistant