Provider Demographics
NPI:1295464329
Name:PATEL, NIKUNJ KIRIT (DMD)
Entity Type:Individual
Prefix:
First Name:NIKUNJ
Middle Name:KIRIT
Last Name:PATEL
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4654 CONCORD CIR
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18045-8130
Mailing Address - Country:US
Mailing Address - Phone:732-261-2494
Mailing Address - Fax:
Practice Address - Street 1:2431 EASTON AVE
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18017-5075
Practice Address - Country:US
Practice Address - Phone:732-261-2494
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-06
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0436491223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice