Provider Demographics
NPI:1932866183
Name:ASHOKKUMAR S. MEHTA D.D.S, INC
Entity Type:Organization
Organization Name:ASHOKKUMAR S. MEHTA D.D.S, INC
Other - Org Name:MEHTA DENTAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:D.D.S/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ASHOKKUMAR
Authorized Official - Middle Name:SHANTILAL
Authorized Official - Last Name:MEHTA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:714-928-4299
Mailing Address - Street 1:330 N STATE COLLEGE BLVD
Mailing Address - Street 2:105
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92806
Mailing Address - Country:US
Mailing Address - Phone:714-772-5005
Mailing Address - Fax:714-772-6942
Practice Address - Street 1:330 N STATE COLLEGE BLVD
Practice Address - Street 2:105
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92806
Practice Address - Country:US
Practice Address - Phone:714-772-5005
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ASHOKKUMAR S. MEHTA D.D.S., INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-11-23
Last Update Date:2022-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Multi-Specialty