Provider Demographics
NPI:1629564539
Name:PATEL, NAYAN RAJ (DDS)
Entity Type:Individual
Prefix:DR
First Name:NAYAN
Middle Name:RAJ
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 1:3116 WEDDINGTON RD STE 900
Mailing Address - Street 2:
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28105-9407
Mailing Address - Country:US
Mailing Address - Phone:252-452-1717
Mailing Address - Fax:
Practice Address - Street 1:3693 NEW BERN AVE
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27610-1232
Practice Address - Country:US
Practice Address - Phone:919-231-3251
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-03
Last Update Date:2018-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11168122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist