Provider Demographics
NPI:1083603153
Name:PATEL, SAILESH SURYAKANT (DMD)
Entity Type:Individual
Prefix:
First Name:SAILESH
Middle Name:SURYAKANT
Last Name:PATEL
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 N 7TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040-3026
Mailing Address - Country:US
Mailing Address - Phone:516-775-0850
Mailing Address - Fax:
Practice Address - Street 1:1417 WYTHE PL
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10452-6932
Practice Address - Country:US
Practice Address - Phone:718-590-4678
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY039982122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist