Provider Demographics
NPI:1437710993
Name:PATEL, KISHAN SHAILESH (DDS)
Entity Type:Individual
Prefix:DR
First Name:KISHAN
Middle Name:SHAILESH
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 1:829 FOLSOM ST UNIT 418
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94107-6114
Mailing Address - Country:US
Mailing Address - Phone:951-760-9298
Mailing Address - Fax:
Practice Address - Street 1:1172 CADILLAC CT
Practice Address - Street 2:
Practice Address - City:MILPITAS
Practice Address - State:CA
Practice Address - Zip Code:95035-3025
Practice Address - Country:US
Practice Address - Phone:408-946-9800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-25
Last Update Date:2019-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA103856122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist