Provider Demographics
NPI:1558530154
Name:BHARAT S PATEL
Entity Type:Organization
Organization Name:BHARAT S PATEL
Other - Org Name:BELL DENTAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BHARAT
Authorized Official - Middle Name:S
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:602-866-0420
Mailing Address - Street 1:17223 N 19TH AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85023-2407
Mailing Address - Country:US
Mailing Address - Phone:602-866-0420
Mailing Address - Fax:
Practice Address - Street 1:17223 N 19TH AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85023-2407
Practice Address - Country:US
Practice Address - Phone:602-866-0420
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-27
Last Update Date:2008-09-02
Deactivation Date:2008-07-17
Deactivation Code:
Reactivation Date:2008-09-02
Provider Licenses
StateLicense IDTaxonomies
AZ3343122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ106320Medicare PIN