Provider Demographics
NPI:1730445990
Name:BRACE YOURSELF ORTHODONTICS, INC. / JAY PAREKH DDS, MS
Entity type:Organization
Organization Name:BRACE YOURSELF ORTHODONTICS, INC. / JAY PAREKH DDS, MS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / ORTHODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JAY
Authorized Official - Middle Name:
Authorized Official - Last Name:PAREKH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:513-335-2342
Mailing Address - Street 1:5526 WINDING CAPE WAY
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:OH
Mailing Address - Zip Code:45040-5017
Mailing Address - Country:US
Mailing Address - Phone:513-335-2342
Mailing Address - Fax:
Practice Address - Street 1:1611 27TH ST STE 203
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:OH
Practice Address - Zip Code:45662-6932
Practice Address - Country:US
Practice Address - Phone:740-353-1253
Practice Address - Fax:740-354-4754
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-02
Last Update Date:2013-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.0220561223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty