Provider Demographics
NPI:1497867535
Name:PATEL, DHARTI NATAVARBHAI (DMD)
Entity Type:Individual
Prefix:MISS
First Name:DHARTI
Middle Name:NATAVARBHAI
Last Name:PATEL
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10214 N TATUM BLVD STE A1100
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85028-4243
Mailing Address - Country:US
Mailing Address - Phone:845-480-4865
Mailing Address - Fax:
Practice Address - Street 1:10214 N TATUM BLVD STE A1100
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85028-4243
Practice Address - Country:US
Practice Address - Phone:602-992-1486
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2021-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ9085122300000X, 125Q00000X, 1223X2210X
NY0509071122300000X, 1223X2210X, 125Q00000X
AZ19-1790175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X2210XDental ProvidersDentistOrofacial Pain
No122300000XDental ProvidersDentist
No125Q00000XDental ProvidersOral Medicinist
No175F00000XOther Service ProvidersNaturopath