Provider Demographics
NPI:1497987366
Name:PATEL, KINJAL MUKEH (DDS)
Entity Type:Individual
Prefix:DR
First Name:KINJAL
Middle Name:MUKEH
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 1:10801 MAIN ST
Mailing Address - Street 2:APT 5401
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-4727
Mailing Address - Country:US
Mailing Address - Phone:703-352-2500
Mailing Address - Fax:
Practice Address - Street 1:10801 MAIN ST
Practice Address - Street 2:SUITE 500 AND 600
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-4727
Practice Address - Country:US
Practice Address - Phone:703-532-2500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-11
Last Update Date:2016-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014125061223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice