Provider Demographics
NPI:1740414663
Name:PATEL, JIGNA A (DDS)
Entity Type:Individual
Prefix:
First Name:JIGNA
Middle Name:A
Last Name:PATEL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1011 CROFFT DR
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-4889
Mailing Address - Country:US
Mailing Address - Phone:732-662-0136
Mailing Address - Fax:
Practice Address - Street 1:313 PRIMROSE LN
Practice Address - Street 2:
Practice Address - City:MOUNTVILLE
Practice Address - State:PA
Practice Address - Zip Code:17554-1229
Practice Address - Country:US
Practice Address - Phone:732-662-0136
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-06
Last Update Date:2015-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0375891223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice