Provider Demographics
NPI:1265816797
Name:PATEL, HASMI
Entity Type:Individual
Prefix:DR
First Name:HASMI
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4514 OLD MONROE RD STE E
Mailing Address - Street 2:
Mailing Address - City:INDIAN TRAIL
Mailing Address - State:NC
Mailing Address - Zip Code:28079-5308
Mailing Address - Country:US
Mailing Address - Phone:704-839-2434
Mailing Address - Fax:
Practice Address - Street 1:4514 OLD MONROE RD STE E
Practice Address - Street 2:
Practice Address - City:INDIAN TRAIL
Practice Address - State:NC
Practice Address - Zip Code:28079-5308
Practice Address - Country:US
Practice Address - Phone:704-839-2434
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-15
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0405501223G0001X
NC101911223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice