Provider Demographics
NPI:1003088576
Name:PATEL, JIGISHA K (DENTIST)
Entity Type:Individual
Prefix:DR
First Name:JIGISHA
Middle Name:K
Last Name:PATEL
Suffix:
Gender:F
Credentials:DENTIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6128 PRESTLEY MILL RD
Mailing Address - Street 2:SUITE-E
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30134-5621
Mailing Address - Country:US
Mailing Address - Phone:770-949-0434
Mailing Address - Fax:770-949-0886
Practice Address - Street 1:6128 PRESTLEY MILL RD
Practice Address - Street 2:SUITE-E
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30134-5621
Practice Address - Country:US
Practice Address - Phone:770-949-0434
Practice Address - Fax:770-949-0886
Is Sole Proprietor?:No
Enumeration Date:2008-03-25
Last Update Date:2008-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAGA-0113581223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice