Provider Demographics
NPI:1225037963
Name:PATEL, MINESH Y (DDS)
Entity Type:Individual
Prefix:DR
First Name:MINESH
Middle Name:Y
Last Name:PATEL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:7548 TAGG DR
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38138-5827
Mailing Address - Country:US
Mailing Address - Phone:901-753-2958
Mailing Address - Fax:731-424-9719
Practice Address - Street 1:1523 S HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38301-7520
Practice Address - Country:US
Practice Address - Phone:731-424-6452
Practice Address - Fax:731-424-9719
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS00000072451223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice