Provider Demographics
NPI:1699367193
Name:PATEL, NISHA S (RDH)
Entity Type:Individual
Prefix:MRS
First Name:NISHA
Middle Name:S
Last Name:PATEL
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:760 N DENTON TAP RD COPPELL SMILES
Mailing Address - Street 2:#190
Mailing Address - City:COPPELL
Mailing Address - State:TX
Mailing Address - Zip Code:75019
Mailing Address - Country:US
Mailing Address - Phone:972-315-2200
Mailing Address - Fax:972-315-2204
Practice Address - Street 1:760 N DENTON TAP RD
Practice Address - Street 2:#190
Practice Address - City:COPPELL
Practice Address - State:TX
Practice Address - Zip Code:75019
Practice Address - Country:US
Practice Address - Phone:972-315-2200
Practice Address - Fax:972-315-2204
Is Sole Proprietor?:No
Enumeration Date:2021-02-05
Last Update Date:2021-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX21978124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist