Provider Demographics
NPI:1407986805
Name:PATEL, RAJNIKANT M (DDS)
Entity Type:Individual
Prefix:DR
First Name:RAJNIKANT
Middle Name:M
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 1:260 E ONTARIO AVE
Mailing Address - Street 2:STE #102
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92879-3506
Mailing Address - Country:US
Mailing Address - Phone:951-278-9000
Mailing Address - Fax:951-278-9080
Practice Address - Street 1:260 E ONTARIO AVE
Practice Address - Street 2:STE #102
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92879-3506
Practice Address - Country:US
Practice Address - Phone:951-278-9000
Practice Address - Fax:951-278-9080
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2013-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA38898122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist