Provider Demographics
NPI:1518296466
Name:PATEL AND SHAH DENTAL CARE
Entity Type:Organization
Organization Name:PATEL AND SHAH DENTAL CARE
Other - Org Name:ORANGE SMILES DENTAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BELA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:714-639-6410
Mailing Address - Street 1:845 W. LAVETA AVE.
Mailing Address - Street 2:SUITE #109
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-3930
Mailing Address - Country:US
Mailing Address - Phone:714-639-6410
Mailing Address - Fax:714-639-1749
Practice Address - Street 1:845 W. LAVETA AVE.
Practice Address - Street 2:SUITE #109
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-3930
Practice Address - Country:US
Practice Address - Phone:714-639-6410
Practice Address - Fax:714-639-1749
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-23
Last Update Date:2009-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAI-124930-L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty