Individual
SHIVAM YOGESH MEHTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BDS, MDS, MDENTSC
Contact information
Practice address
3806 E BROAD ST STE 108, MANSFIELD, TX 76063-5621
(773) 231-3050
Mailing address
1100 LAKE CAROLYN PKWY APT 3027, IRVING, TX 75039-4715
(773) 231-3050
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
38698
TX
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
38698
TX
Other
Enumeration date
07/16/2018
Last updated
01/02/2024
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