Provider Demographics
NPI:1659608081
Name:JAYESH S. PATEL, DDS, PA
Entity Type:Organization
Organization Name:JAYESH S. PATEL, DDS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAYESH
Authorized Official - Middle Name:S
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:254-741-9324
Mailing Address - Street 1:2511 AMBASSADOR DR
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76712-8944
Mailing Address - Country:US
Mailing Address - Phone:254-741-9324
Mailing Address - Fax:254-752-2444
Practice Address - Street 1:2511 AMBASSADOR DR
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76712-8944
Practice Address - Country:US
Practice Address - Phone:254-741-9324
Practice Address - Fax:254-752-2444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-05
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX206151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty