Provider Demographics
NPI:1952813305
Name:MAHANT DENTAL
Entity Type:Organization
Organization Name:MAHANT DENTAL
Other - Org Name:COTTONWOOD DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:MEGHA
Authorized Official - Middle Name:L
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:313-399-9078
Mailing Address - Street 1:3989 N BELT LINE RD
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75038-5706
Mailing Address - Country:US
Mailing Address - Phone:972-261-1166
Mailing Address - Fax:972-261-1166
Practice Address - Street 1:3989 N BELT LINE RD
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75038-5706
Practice Address - Country:US
Practice Address - Phone:972-261-1166
Practice Address - Fax:972-433-6475
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-25
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1223G0001X
TX27383261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
No261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental