Provider Demographics
NPI:1447241583
Name:PATEL, RAJNI P (DDS)
Entity Type:Individual
Prefix:DR
First Name:RAJNI
Middle Name:P
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 1:5 PIONEER TRL
Mailing Address - Street 2:
Mailing Address - City:ARMONK
Mailing Address - State:NY
Mailing Address - Zip Code:10504-1500
Mailing Address - Country:US
Mailing Address - Phone:718-292-6946
Mailing Address - Fax:718-292-6525
Practice Address - Street 1:5 PIONEER TRL
Practice Address - Street 2:
Practice Address - City:ARMONK
Practice Address - State:NY
Practice Address - Zip Code:10504-1500
Practice Address - Country:US
Practice Address - Phone:718-292-6946
Practice Address - Fax:718-292-6525
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0345631223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00413158Medicaid