1144538075 NPI number — LXMI, INC.

Table of content: (NPI 1144538075)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144538075 NPI number — LXMI, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LXMI, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
TARAK C. PATEL, DDS
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1144538075
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/14/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2262 DUNN AVENUE
Provider Second Line Business Mailing Address:
SUITE 1
Provider Business Mailing Address City Name:
JACKSONVILLE
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32218
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
904-757-7940
Provider Business Mailing Address Fax Number:
904-757-7942

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2262 DUNN AVENUE
Provider Second Line Business Practice Location Address:
SUITE 1
Provider Business Practice Location Address City Name:
JACKSONVILLE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32218
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
904-757-7940
Provider Business Practice Location Address Fax Number:
904-757-7942
Provider Enumeration Date:
09/14/2010

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
PATEL
Authorized Official First Name:
TARAK
Authorized Official Middle Name:
CHAMPAKLAL
Authorized Official Title or Position:
DENTIST
Authorized Official Telephone Number:
904-757-7940

Provider Taxonomy Codes

  • Taxonomy code: 122300000X , with the licence number:  DN14212 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 122300000X , with the licence number: DN18785 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 124Q00000X , with the licence number: DH10367 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 124Q00000X , with the licence number: DH15676 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)