Provider Demographics
NPI:1275235129
Name:DOSHI, ANISH (DDS)
Entity type:Individual
Prefix:
First Name:ANISH
Middle Name:
Last Name:DOSHI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:905 KENILWORTH AVE APT 585
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28204-3531
Mailing Address - Country:US
Mailing Address - Phone:434-466-1867
Mailing Address - Fax:
Practice Address - Street 1:620 N CHURCH ST STE 113
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28202-3277
Practice Address - Country:US
Practice Address - Phone:704-705-1646
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-21
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC13595122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist