Provider Demographics
NPI:1164659124
Name:DHALIWAL, AVNI PATEL (DDS)
Entity Type:Individual
Prefix:DR
First Name:AVNI
Middle Name:PATEL
Last Name:DHALIWAL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2700 WESTHALL LN # 121
Mailing Address - Street 2:
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-7203
Mailing Address - Country:US
Mailing Address - Phone:407-335-4600
Mailing Address - Fax:407-335-4618
Practice Address - Street 1:2700 WESTHALL LN # 121
Practice Address - Street 2:
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-7203
Practice Address - Country:US
Practice Address - Phone:407-335-4600
Practice Address - Fax:407-335-4618
Is Sole Proprietor?:No
Enumeration Date:2009-06-17
Last Update Date:2020-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN232611223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice