Provider Demographics
NPI:1750635520
Name:PATEL, BINITA S (DMD)
Entity Type:Individual
Prefix:
First Name:BINITA
Middle Name:S
Last Name:PATEL
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7828 WINTER GARDEN VINELAND RD
Mailing Address - Street 2:SUITE 128
Mailing Address - City:WINDERMERE
Mailing Address - State:FL
Mailing Address - Zip Code:34786-5933
Mailing Address - Country:US
Mailing Address - Phone:407-614-8796
Mailing Address - Fax:407-614-4516
Practice Address - Street 1:7828 WINTER GARDEN VINELAND RD
Practice Address - Street 2:SUITE 128
Practice Address - City:WINDERMERE
Practice Address - State:FL
Practice Address - Zip Code:34786-5933
Practice Address - Country:US
Practice Address - Phone:407-614-8796
Practice Address - Fax:407-614-4516
Is Sole Proprietor?:No
Enumeration Date:2012-11-01
Last Update Date:2012-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN19971122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist