Provider Demographics
NPI:1679271985
Name:BYUN, HA, AND PATEL DDS, INC.
Entity Type:Organization
Organization Name:BYUN, HA, AND PATEL DDS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CORP SECRETARY
Authorized Official - Prefix:DR
Authorized Official - First Name:JETAN
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:562-967-0126
Mailing Address - Street 1:12292 NANTUCKET PL
Mailing Address - Street 2:
Mailing Address - City:SEAL BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90740-2772
Mailing Address - Country:US
Mailing Address - Phone:562-967-0126
Mailing Address - Fax:
Practice Address - Street 1:1872 N TUSTIN ST
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92865-4605
Practice Address - Country:US
Practice Address - Phone:714-637-8662
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-16
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental