Provider Demographics
NPI:1821624909
Name:MEGHPARA, BHARGAV V
Entity type:Individual
Prefix:
First Name:BHARGAV
Middle Name:V
Last Name:MEGHPARA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 TIMBER TRL
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18045-8706
Mailing Address - Country:US
Mailing Address - Phone:862-579-7580
Mailing Address - Fax:
Practice Address - Street 1:101 S SCHANCK AVE
Practice Address - Street 2:
Practice Address - City:PEN ARGYL
Practice Address - State:PA
Practice Address - Zip Code:18072-1667
Practice Address - Country:US
Practice Address - Phone:862-579-7580
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-20
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0431031223G0001X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program