Provider Demographics
NPI:1083013445
Name:MEHTA, MAHEK
Entity type:Individual
Prefix:
First Name:MAHEK
Middle Name:
Last Name:MEHTA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 DANIEL WEBSTER HWY
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03060-5536
Mailing Address - Country:US
Mailing Address - Phone:603-505-4190
Mailing Address - Fax:
Practice Address - Street 1:225 DANIEL WEBSTER HWY
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03060-5536
Practice Address - Country:US
Practice Address - Phone:603-505-4190
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-21
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH04083122300000X, 122300000X
VT016.0106093122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist