Provider Demographics
NPI:1326261058
Name:PATEL, SNEHAL (DDS, MD)
Entity Type:Individual
Prefix:DR
First Name:SNEHAL
Middle Name:
Last Name:PATEL
Suffix:
Gender:M
Credentials:DDS, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:604 BEULAH RD NE
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22180-3511
Mailing Address - Country:US
Mailing Address - Phone:347-886-2844
Mailing Address - Fax:703-263-3148
Practice Address - Street 1:604 BEULAH RD NE
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22180-3511
Practice Address - Country:US
Practice Address - Phone:347-886-2844
Practice Address - Fax:703-263-3148
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2009-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD140111223S0112X
DC10006201223S0112X
DCMD036657204E00000X
MDD66183204E00000X
VA04014119481223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery