Provider Demographics
NPI:1790149193
Name:PATEL, PAYAL (DDS)
Entity Type:Individual
Prefix:DR
First Name:PAYAL
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 1:4007 HOOSIER LAWN WAY
Mailing Address - Street 2:
Mailing Address - City:YORBA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92886-7026
Mailing Address - Country:US
Mailing Address - Phone:714-606-8455
Mailing Address - Fax:
Practice Address - Street 1:620 N ROSE DR STE B
Practice Address - Street 2:
Practice Address - City:PLACENTIA
Practice Address - State:CA
Practice Address - Zip Code:92870-7524
Practice Address - Country:US
Practice Address - Phone:714-905-5839
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-12
Last Update Date:2020-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADDS1004541223X0400X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics