Provider Demographics
NPI:1356070726
Name:PATEL, KRINA (DDS)
Entity Type:Individual
Prefix:
First Name:KRINA
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 1:128 COLTHORPE LN
Mailing Address - Street 2:
Mailing Address - City:HUTTO
Mailing Address - State:TX
Mailing Address - Zip Code:78634-3352
Mailing Address - Country:US
Mailing Address - Phone:701-781-0866
Mailing Address - Fax:
Practice Address - Street 1:413 N LA SALLE ST
Practice Address - Street 2:
Practice Address - City:NAVASOTA
Practice Address - State:TX
Practice Address - Zip Code:77868-2435
Practice Address - Country:US
Practice Address - Phone:936-825-7799
Practice Address - Fax:936-825-1004
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-09
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX385791223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty