Provider Demographics
NPI:1164860045
Name:PATEL, YAMINI M (BDS)
Entity Type:Individual
Prefix:DR
First Name:YAMINI
Middle Name:M
Last Name:PATEL
Suffix:
Gender:F
Credentials:BDS
Other - Prefix:DR
Other - First Name:YAMINI
Other - Middle Name:A
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BDS
Mailing Address - Street 1:469 MIGEON AVE
Mailing Address - Street 2:
Mailing Address - City:TORRINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06790-4643
Mailing Address - Country:US
Mailing Address - Phone:860-387-0439
Mailing Address - Fax:860-482-3067
Practice Address - Street 1:469 MIGEON AVE
Practice Address - Street 2:
Practice Address - City:TORRINGTON
Practice Address - State:CT
Practice Address - Zip Code:06790-4643
Practice Address - Country:US
Practice Address - Phone:860-387-0439
Practice Address - Fax:860-482-3067
Is Sole Proprietor?:No
Enumeration Date:2013-06-12
Last Update Date:2016-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT115141223G0001X
CT390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program