Provider Demographics
NPI:1336319144
Name:PATEL, AMISHI (DDS)
Entity Type:Individual
Prefix:DR
First Name:AMISHI
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:534 SHOREBIRD CIR UNIT 17202
Mailing Address - Street 2:
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94065-1050
Mailing Address - Country:US
Mailing Address - Phone:650-504-7104
Mailing Address - Fax:
Practice Address - Street 1:10430 S DEANZA BLVD
Practice Address - Street 2:SUITE # 270
Practice Address - City:CUPERTINO
Practice Address - State:CA
Practice Address - Zip Code:95014
Practice Address - Country:US
Practice Address - Phone:408-252-6580
Practice Address - Fax:408-252-6583
Is Sole Proprietor?:No
Enumeration Date:2008-03-07
Last Update Date:2009-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA564951223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice