Provider Demographics
NPI:1063453272
Name:PATEL, MAHESHCHANDRA D (DDS)
Entity Type:Individual
Prefix:DR
First Name:MAHESHCHANDRA
Middle Name:D
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 1:3514 MERMAID AVE
Mailing Address - Street 2:002
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11224-1509
Mailing Address - Country:US
Mailing Address - Phone:718-265-9238
Mailing Address - Fax:718-265-9238
Practice Address - Street 1:3514 MERMAID AVE
Practice Address - Street 2:002
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11224-1509
Practice Address - Country:US
Practice Address - Phone:718-265-9238
Practice Address - Fax:718-265-9238
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0380141223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00980814Medicaid