Provider Demographics
NPI:1083884688
Name:DRS. PATEL, KASHYAP & ASSOCIATES, P.A.
Entity Type:Organization
Organization Name:DRS. PATEL, KASHYAP & ASSOCIATES, P.A.
Other - Org Name:MATTHEWS FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE-PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:VIVEK
Authorized Official - Middle Name:
Authorized Official - Last Name:KASHYAP
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:704-708-9185
Mailing Address - Street 1:1340 MATTHEWS TOWNSHIP PKWY
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28105-5580
Mailing Address - Country:US
Mailing Address - Phone:704-708-9185
Mailing Address - Fax:704-708-9192
Practice Address - Street 1:1340 MATTHEWS TOWNSHIP PKWY
Practice Address - Street 2:SUITE 101
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105-5580
Practice Address - Country:US
Practice Address - Phone:704-708-9185
Practice Address - Fax:704-708-9192
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-11
Last Update Date:2008-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC76201223G0001X
NC73141223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty