Provider Demographics
NPI:1467892828
Name:PATEL, DIPALI S (DDS)
Entity Type:Individual
Prefix:DR
First Name:DIPALI
Middle Name:S
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 1:4118 BROWN ST
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75219-3327
Mailing Address - Country:US
Mailing Address - Phone:940-300-0043
Mailing Address - Fax:
Practice Address - Street 1:1418 W JEFFERSON BLVD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75208-5325
Practice Address - Country:US
Practice Address - Phone:940-300-0043
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-01
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX289681223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice