Provider Demographics
NPI:1215183520
Name:PATEL, SANDEEP BABUBHAI (DDS)
Entity Type:Individual
Prefix:DR
First Name:SANDEEP
Middle Name:BABUBHAI
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 1:11215 S IH 35
Mailing Address - Street 2:SUITE #116
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78747-1863
Mailing Address - Country:US
Mailing Address - Phone:512-233-6200
Mailing Address - Fax:512-233-6201
Practice Address - Street 1:11215 S IH 35
Practice Address - Street 2:SUITE #116
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78747-1863
Practice Address - Country:US
Practice Address - Phone:512-233-6200
Practice Address - Fax:512-233-6201
Is Sole Proprietor?:No
Enumeration Date:2008-08-18
Last Update Date:2008-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX21274122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist