Provider Demographics
NPI:1508079609
Name:USHMA PATEL D.M.D., P.C.
Entity Type:Organization
Organization Name:USHMA PATEL D.M.D., P.C.
Other - Org Name:CENTER FOR ADVANCED DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:USHMA
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:770-623-8750
Mailing Address - Street 1:6916 MCGINNIS FERRY RD
Mailing Address - Street 2:SUITE 500
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-1258
Mailing Address - Country:US
Mailing Address - Phone:770-623-8750
Mailing Address - Fax:
Practice Address - Street 1:6916 MCGINNIS FERRY RD
Practice Address - Street 2:SUITE 500
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-1258
Practice Address - Country:US
Practice Address - Phone:770-623-8750
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-07
Last Update Date:2010-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0117121223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty