Provider Demographics
NPI:1578021465
Name:PATEL, SAAVAN JAGDISH (DDS)
Entity Type:Individual
Prefix:
First Name:SAAVAN
Middle Name:JAGDISH
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 1:3943 59TH ST
Mailing Address - Street 2:
Mailing Address - City:WOODSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11377-3435
Mailing Address - Country:US
Mailing Address - Phone:347-334-9804
Mailing Address - Fax:
Practice Address - Street 1:3766 82ND ST
Practice Address - Street 2:
Practice Address - City:JACKSON HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11372-7006
Practice Address - Country:US
Practice Address - Phone:718-639-7100
Practice Address - Fax:718-725-7132
Is Sole Proprietor?:No
Enumeration Date:2019-03-09
Last Update Date:2020-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NY0612391223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program