Provider Demographics
NPI:1821225657
Name:PATEL, AMISH H (DDS)
Entity Type:Individual
Prefix:
First Name:AMISH
Middle Name:H
Last Name:PATEL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:413 S 10TH ST
Mailing Address - Street 2:
Mailing Address - City:ATCHISON
Mailing Address - State:KS
Mailing Address - Zip Code:66002-2771
Mailing Address - Country:US
Mailing Address - Phone:913-367-0203
Mailing Address - Fax:913-367-5037
Practice Address - Street 1:413 S 10TH ST
Practice Address - Street 2:
Practice Address - City:ATCHISON
Practice Address - State:KS
Practice Address - Zip Code:66002-2771
Practice Address - Country:US
Practice Address - Phone:913-367-0203
Practice Address - Fax:913-367-5037
Is Sole Proprietor?:No
Enumeration Date:2009-06-19
Last Update Date:2016-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS61282122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist