Provider Demographics
NPI:1386082543
Name:MEHTA, RAHUL (DMD)
Entity type:Individual
Prefix:
First Name:RAHUL
Middle Name:
Last Name:MEHTA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20057 INTERSTATE 45 N
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77388-6303
Mailing Address - Country:US
Mailing Address - Phone:281-805-7086
Mailing Address - Fax:281-805-7080
Practice Address - Street 1:20057 INTERSTATE 45 N
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77388-6303
Practice Address - Country:US
Practice Address - Phone:281-805-7086
Practice Address - Fax:281-805-7080
Is Sole Proprietor?:No
Enumeration Date:2013-06-10
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX303121223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice