Provider Demographics
NPI:1407948631
Name:PATEL, KAMLESHKUMAR HIRABHAI (DDS)
Entity Type:Individual
Prefix:
First Name:KAMLESHKUMAR
Middle Name:HIRABHAI
Last Name:PATEL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10645 IMPERIAL HWY
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CA
Mailing Address - Zip Code:90650-2136
Mailing Address - Country:US
Mailing Address - Phone:562-651-1064
Mailing Address - Fax:562-651-1094
Practice Address - Street 1:10645 IMPERIAL HWY
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CA
Practice Address - Zip Code:90650-2136
Practice Address - Country:US
Practice Address - Phone:562-651-1064
Practice Address - Fax:562-651-1094
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA39997122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist