Provider Demographics
NPI:1760524086
Name:PATEL, ULPA (DDS)
Entity Type:Individual
Prefix:DR
First Name:ULPA
Middle Name:
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 1:8135 ROYAL SAINT GEORGES LN
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30097-1650
Mailing Address - Country:US
Mailing Address - Phone:167-835-7876
Mailing Address - Fax:770-441-0299
Practice Address - Street 1:200 E PONCE DE LEON AVE STE 300
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30030-3469
Practice Address - Country:US
Practice Address - Phone:678-357-8762
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0124221223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry