Provider Demographics
NPI:1508549866
Name:PATEL, ALEXIS KARISHMA (DMD)
Entity Type:Individual
Prefix:DR
First Name:ALEXIS
Middle Name:KARISHMA
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 1:3916 PERCHERON DR
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29429-4977
Mailing Address - Country:US
Mailing Address - Phone:843-303-4634
Mailing Address - Fax:
Practice Address - Street 1:206 AIRPORT RD
Practice Address - Street 2:
Practice Address - City:KINSTON
Practice Address - State:NC
Practice Address - Zip Code:28504-8814
Practice Address - Country:US
Practice Address - Phone:252-522-1777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-11
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC13431122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist