Provider Demographics
NPI:1700016177
Name:PATEL, VINAY N (DDS)
Entity Type:Individual
Prefix:DR
First Name:VINAY
Middle Name:N
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 1:1162 S ROSELLE RD
Mailing Address - Street 2:P.O. BOX 68875
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60193-4072
Mailing Address - Country:US
Mailing Address - Phone:847-584-0134
Mailing Address - Fax:
Practice Address - Street 1:1162 S ROSELLE RD
Practice Address - Street 2:
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60193-4072
Practice Address - Country:US
Practice Address - Phone:847-584-0134
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-20
Last Update Date:2009-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190225971223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice