Provider Demographics
NPI:1770360042
Name:PATEL, BHAVINKUMAR BALENDRAKUMAR (BDS, MS)
Entity type:Individual
Prefix:DR
First Name:BHAVINKUMAR
Middle Name:BALENDRAKUMAR
Last Name:PATEL
Suffix:
Gender:M
Credentials:BDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7826 CORNERS COVE ST
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49009
Mailing Address - Country:US
Mailing Address - Phone:440-231-8738
Mailing Address - Fax:
Practice Address - Street 1:4209 OH-44
Practice Address - Street 2:
Practice Address - City:ROOTSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44272
Practice Address - Country:US
Practice Address - Phone:330-325-6302
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-11
Last Update Date:2025-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901601924122300000X
OH30.0277451223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0700XDental ProvidersDentistProsthodontics
No122300000XDental ProvidersDentistGroup - Single Specialty