Provider Demographics
NPI:1417064130
Name:PATEL, PRITI A (DDS)
Entity Type:Individual
Prefix:DR
First Name:PRITI
Middle Name:A
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 1:15066 LOS GATOS ALMADEN RD
Mailing Address - Street 2:
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95032-3909
Mailing Address - Country:US
Mailing Address - Phone:408-559-8220
Mailing Address - Fax:408-559-8223
Practice Address - Street 1:15066 LOS GATOS ALMADEN RD
Practice Address - Street 2:
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-3909
Practice Address - Country:US
Practice Address - Phone:408-559-8220
Practice Address - Fax:408-559-8223
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA396931223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice