Provider Demographics
NPI:1033447602
Name:PATEL, BHAVIN C (DDS)
Entity Type:Individual
Prefix:DR
First Name:BHAVIN
Middle Name:C
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 1:28 TROUT BROOK LN
Mailing Address - Street 2:
Mailing Address - City:MENDHAM
Mailing Address - State:NJ
Mailing Address - Zip Code:07945-2155
Mailing Address - Country:US
Mailing Address - Phone:646-258-3580
Mailing Address - Fax:
Practice Address - Street 1:330 LIVINGSTON AVE
Practice Address - Street 2:
Practice Address - City:NEW BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08901-3469
Practice Address - Country:US
Practice Address - Phone:732-846-8383
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-19
Last Update Date:2009-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI 023802001223G0001X
NY0510781223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice