Provider Demographics
NPI:1326202979
Name:SHAHPATEL, KHYATI DHIREN (DMD)
Entity Type:Individual
Prefix:DR
First Name:KHYATI
Middle Name:DHIREN
Last Name:SHAHPATEL
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:876 BUFORD RD
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30041-2716
Mailing Address - Country:US
Mailing Address - Phone:216-280-8556
Mailing Address - Fax:
Practice Address - Street 1:876 BUFORD RD
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30041-2716
Practice Address - Country:US
Practice Address - Phone:216-280-8556
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-022745122300000X
GADN014994122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
1326202979OtherGEORGIA