Provider Demographics
NPI:1487821450
Name:PATEL, REENA MULJIBHAI (DDS)
Entity Type:Individual
Prefix:MRS
First Name:REENA
Middle Name:MULJIBHAI
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:WAKE FOREST UNIVERSITY SCHOOL OF MEDICINE
Mailing Address - Street 2:DEPARTMENT OF DENTISTRY
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27157-0001
Mailing Address - Country:US
Mailing Address - Phone:336-716-4353
Mailing Address - Fax:
Practice Address - Street 1:WAKE FOREST UNIVERSITY SCHOOL OF MEDICINE
Practice Address - Street 2:DEPARTMENT OF DENTISTRY
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27157-0001
Practice Address - Country:US
Practice Address - Phone:336-716-2160
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-09
Last Update Date:2008-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1506331223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice