Provider Demographics
NPI:1033177860
Name:PATEL, TRUSHYAP RAVAJIBHAI (DDS)
Entity Type:Individual
Prefix:DR
First Name:TRUSHYAP
Middle Name:RAVAJIBHAI
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 1:2279 WICKLOW ST
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96001-6001
Mailing Address - Country:US
Mailing Address - Phone:530-242-9266
Mailing Address - Fax:530-242-9266
Practice Address - Street 1:2147 COURT ST
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-2531
Practice Address - Country:US
Practice Address - Phone:530-246-4100
Practice Address - Fax:530-246-4266
Is Sole Proprietor?:No
Enumeration Date:2006-05-02
Last Update Date:2013-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAD-50969122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist