Provider Demographics
NPI:1477282952
Name:PATEL, DHARMIK UMESHBHAI (DDS)
Entity Type:Individual
Prefix:
First Name:DHARMIK
Middle Name:UMESHBHAI
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 1:2639 SHOWPLACE DR UNIT 201
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60564-3330
Mailing Address - Country:US
Mailing Address - Phone:630-605-4504
Mailing Address - Fax:
Practice Address - Street 1:2879 95TH ST STE 131
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60564-9008
Practice Address - Country:US
Practice Address - Phone:630-753-9955
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-09
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019034187122300000X
MNSTUDENT1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
No1223G0001XDental ProvidersDentistGeneral Practice