Provider Demographics
NPI:1649567447
Name:PATEL, CHIRAG B (DMD)
Entity Type:Individual
Prefix:DR
First Name:CHIRAG
Middle Name:B
Last Name:PATEL
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:232 BLOOMFIELD ST
Mailing Address - Street 2:
Mailing Address - City:HOBOKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07030-4724
Mailing Address - Country:US
Mailing Address - Phone:201-798-8899
Mailing Address - Fax:
Practice Address - Street 1:232 BLOOMFIELD ST
Practice Address - Street 2:
Practice Address - City:HOBOKEN
Practice Address - State:NJ
Practice Address - Zip Code:07030-4724
Practice Address - Country:US
Practice Address - Phone:201-798-8899
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-30
Last Update Date:2015-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI025102001223P0221X
NY056051-11223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry