Provider Demographics
NPI:1790949808
Name:PATIL, HEMAVATHI (DDS)
Entity Type:Individual
Prefix:
First Name:HEMAVATHI
Middle Name:
Last Name:PATIL
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 1:1434 N CENTRAL EXPY STE 121
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-3108
Mailing Address - Country:US
Mailing Address - Phone:972-542-4402
Mailing Address - Fax:972-542-2553
Practice Address - Street 1:1434 N CENTRAL EXPY STE 121
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-3108
Practice Address - Country:US
Practice Address - Phone:972-542-4402
Practice Address - Fax:972-542-4402
Is Sole Proprietor?:No
Enumeration Date:2008-07-17
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190277631223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice