Provider Demographics
NPI:1518346352
Name:PATEL, BRIJESH N (DDS)
Entity Type:Individual
Prefix:
First Name:BRIJESH
Middle Name:N
Last Name:PATEL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1804 PADDINGTON CT
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76017-7925
Mailing Address - Country:US
Mailing Address - Phone:678-735-2602
Mailing Address - Fax:
Practice Address - Street 1:1204 WOODHAVEN BLVD
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76112-2376
Practice Address - Country:US
Practice Address - Phone:678-735-2602
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-26
Last Update Date:2022-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS040768122300000X
IN12012305A122300000X
TX31417122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist