Provider Demographics
NPI:1003964107
Name:PATEL, ALPESH K (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALPESH
Middle Name:K
Last Name:PATEL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17644 VALLEY BLVD
Mailing Address - Street 2:UNITA # 1
Mailing Address - City:BLOOMINGTON
Mailing Address - State:CA
Mailing Address - Zip Code:92316-1947
Mailing Address - Country:US
Mailing Address - Phone:909-877-0650
Mailing Address - Fax:
Practice Address - Street 1:17644 VALLEY BLVD
Practice Address - Street 2:UNIT # 1
Practice Address - City:FONTANA
Practice Address - State:CA
Practice Address - Zip Code:92316-1947
Practice Address - Country:US
Practice Address - Phone:909-877-0650
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2009-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA508101223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice