Provider Demographics
NPI:1265648588
Name:PATEL, KAMLESH G (DMD)
Entity Type:Individual
Prefix:DR
First Name:KAMLESH
Middle Name:G
Last Name:PATEL
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:KAMLESH
Other - Middle Name:GORDHANBHAI
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DMD
Mailing Address - Street 1:7625 MAPLE LAWN BLVD
Mailing Address - Street 2:SUITE 250
Mailing Address - City:FULTON
Mailing Address - State:MD
Mailing Address - Zip Code:20759-2565
Mailing Address - Country:US
Mailing Address - Phone:301-776-9500
Mailing Address - Fax:301-776-9520
Practice Address - Street 1:7625 MAPLE LAWN BLVD
Practice Address - Street 2:SUITE 250
Practice Address - City:FULTON
Practice Address - State:MD
Practice Address - Zip Code:20759-2565
Practice Address - Country:US
Practice Address - Phone:301-776-9500
Practice Address - Fax:301-776-9520
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2010-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD111921223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics