Provider Demographics
NPI:1316214943
Name:PATEL, NIRAV ASHOK (DMD)
Entity Type:Individual
Prefix:DR
First Name:NIRAV
Middle Name:ASHOK
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 1:8654 MARLAMOOR LN
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33412-1603
Mailing Address - Country:US
Mailing Address - Phone:561-506-4155
Mailing Address - Fax:
Practice Address - Street 1:8654 MARLAMOOR LN
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33412-1603
Practice Address - Country:US
Practice Address - Phone:561-506-4155
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-28
Last Update Date:2011-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY055853-1122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist