Individual provider Active NPI

Mayur Jayantilal Mehta, DDS.,MD.PA.

  • General Practice Dentistry
  • Palm Harbor, FL
National Provider Identifier
1598887150
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN0011489 Issued in FL
Practice address
3488 E Lake Rd
Suite 401
Palm Harbor, FL 34685-2404
Phone
(727) 785-7461
Fax
(727) 786-1065
NPI assigned
Apr 4, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN0011489 FL Primary

Addresses

Primary practice location

3488 E Lake Rd
Suite 401
Palm Harbor, FL 34685-2404

Mailing address

3488 E Lake Rd
Suite 401
Palm Harbor, FL 34685-2404
Phone (727) 785-7461

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161215001941 FL Order and Referring Only - DentistPractitioner - Dentist 7618257312

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1598887150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3488 E LAKE RD",
            "address_2": "SUITE 401",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346852404",
            "telephone_number": "727-785-7461",
            "fax_number": "727-786-1065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3488 E LAKE RD",
            "address_2": "SUITE 401",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346852404",
            "telephone_number": "727-785-7461",
            "fax_number": "727-786-1065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEHTA",
        "first_name": "MAYUR",
        "middle_name": "JAYANTILAL",
        "name_prefix": "Dr.",
        "credential": "DDS.,MD.PA.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN0011489",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Harbor, FL

Sources for this page

Verify at the official NPI Registry.