Provider Demographics
NPI:1760111769
Name:PATEL, SAJNI (DMD)
Entity Type:Individual
Prefix:
First Name:SAJNI
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:SAJNI
Other - Middle Name:
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD
Mailing Address - Street 1:727 W MADISON ST APT 1406
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60661-2409
Mailing Address - Country:US
Mailing Address - Phone:708-262-6772
Mailing Address - Fax:
Practice Address - Street 1:GANGER FAMILY DENTISTRY OF CHICAGO
Practice Address - Street 2:1858 W 35TH STREET
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60609
Practice Address - Country:US
Practice Address - Phone:773-247-5554
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-07
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.033593122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist