Provider Demographics
NPI:1295396174
Name:PATEL, JEET R (DDS)
Entity Type:Individual
Prefix:
First Name:JEET
Middle Name:R
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 1:3109 EDGAR BROWN DR
Mailing Address - Street 2:
Mailing Address - City:WEST ORANGE
Mailing Address - State:TX
Mailing Address - Zip Code:77630-5380
Mailing Address - Country:US
Mailing Address - Phone:409-330-4252
Mailing Address - Fax:
Practice Address - Street 1:3109 EDGAR BROWN DR
Practice Address - Street 2:
Practice Address - City:WEST ORANGE
Practice Address - State:TX
Practice Address - Zip Code:77630-5380
Practice Address - Country:US
Practice Address - Phone:409-330-4252
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-22
Last Update Date:2019-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX35370122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist