Provider Demographics
NPI:1417167743
Name:PATEL, HARDEV ARUN (DDS)
Entity Type:Individual
Prefix:DR
First Name:HARDEV
Middle Name:ARUN
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 1:2405 HUNTERS CREEK CV
Mailing Address - Street 2:
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613-5906
Mailing Address - Country:US
Mailing Address - Phone:423-747-8005
Mailing Address - Fax:
Practice Address - Street 1:1906 S COLORADO ST STE 110
Practice Address - Street 2:
Practice Address - City:LOCKHART
Practice Address - State:TX
Practice Address - Zip Code:78644-3906
Practice Address - Country:US
Practice Address - Phone:512-213-1681
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT9542122300000X, 1223G0001X
TX29603122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX29603OtherTX LICENSE NUMBER