Provider Demographics
NPI:1619189479
Name:JIGISHA PATEL DDS, PC
Entity Type:Organization
Organization Name:JIGISHA PATEL DDS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER OF THE PRACTICE
Authorized Official - Prefix:DR
Authorized Official - First Name:JIGISHA
Authorized Official - Middle Name:K
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:770-949-0434
Mailing Address - Street 1:6128 PRESTLEY MILL RD
Mailing Address - Street 2:SUITE E
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30134
Mailing Address - Country:US
Mailing Address - Phone:770-949-0434
Mailing Address - Fax:770-949-0886
Practice Address - Street 1:6128 PRESTLEY MILL RD
Practice Address - Street 2:SUITE E
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30134
Practice Address - Country:US
Practice Address - Phone:770-949-0434
Practice Address - Fax:770-949-0886
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty