Basic Information
| Provider Information | |||||||||
| NPI: | 1124512884 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PARIKH | ||||||||
| FirstName: | ARJUN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 705 TOWN BLVD NE APT 669 | ||||||||
| Address2: | |||||||||
| City: | BROOKHAVEN | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303193097 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6788496131 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4600 ROSWELL RD UNIT C120 | ||||||||
| Address2: | |||||||||
| City: | SANDY SPRINGS | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303423189 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4043419593 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/17/2018 | ||||||||
| LastUpdateDate: | 06/17/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 122300000X | DN015674 | GA | Y | Dental Providers | Dentist |
No ID Information.