Provider Demographics
NPI:1568538965
Name:MINESH Y. PATEL, DDS
Entity Type:Organization
Organization Name:MINESH Y. PATEL, DDS
Other - Org Name:FAMILY AND COSMETIC DENTISTRY OF JACKSON
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MRS
Authorized Official - First Name:MISTY
Authorized Official - Middle Name:LEIGH
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:731-424-6452
Mailing Address - Street 1:1523 SOUTH HIGHLAND AVENUE
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38301-7520
Mailing Address - Country:US
Mailing Address - Phone:731-424-6452
Mailing Address - Fax:731-424-9719
Practice Address - Street 1:1523 SOUTH HIGHLAND AVENUE
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38301-7520
Practice Address - Country:US
Practice Address - Phone:731-424-6452
Practice Address - Fax:731-424-9719
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-28
Last Update Date:2011-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty