Provider Demographics
NPI:1851501795
Name:DESAI & PATEL DDS INC.
Entity Type:Organization
Organization Name:DESAI & PATEL DDS INC.
Other - Org Name:LAKESHORE VILLAGE DENTAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:DR
Authorized Official - First Name:MAKBULAHMED
Authorized Official - Middle Name:I
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:951-601-1000
Mailing Address - Street 1:23581 SUNNYMEAD RANCH PKWY STE 124
Mailing Address - Street 2:
Mailing Address - City:MORENO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92557-2868
Mailing Address - Country:US
Mailing Address - Phone:951-601-1000
Mailing Address - Fax:951-601-3519
Practice Address - Street 1:23581 SUNNYMEAD RANCH PKWY STE 124
Practice Address - Street 2:
Practice Address - City:MORENO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92557-2868
Practice Address - Country:US
Practice Address - Phone:951-601-1000
Practice Address - Fax:951-601-3519
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA370001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty