Provider Demographics
NPI:1174660799
Name:PATEL, VIKAS D (DDS)
Entity Type:Individual
Prefix:
First Name:VIKAS
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 1:1893 N TUSTIN ST
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92865-4604
Mailing Address - Country:US
Mailing Address - Phone:714-637-9933
Mailing Address - Fax:714-637-9909
Practice Address - Street 1:1893 N TUSTIN ST
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92865-4604
Practice Address - Country:US
Practice Address - Phone:714-637-9933
Practice Address - Fax:714-637-9909
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA493901223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice