Provider Demographics
NPI:1497175780
Name:PATEL, JNANA (DDS)
Entity Type:Individual
Prefix:DR
First Name:JNANA
Middle Name:
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 1:416 MATTHEW CT
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94566-7787
Mailing Address - Country:US
Mailing Address - Phone:925-963-3462
Mailing Address - Fax:
Practice Address - Street 1:5901 CHRISTIE AVE
Practice Address - Street 2:SUITE #106
Practice Address - City:EMERYVILLE
Practice Address - State:CA
Practice Address - Zip Code:94608-1930
Practice Address - Country:US
Practice Address - Phone:510-658-9775
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-24
Last Update Date:2014-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA607061223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice