Provider Demographics
NPI:1851538854
Name:PATEL, BHAVIKA PRAVIN (DDS)
Entity Type:Individual
Prefix:DR
First Name:BHAVIKA
Middle Name:PRAVIN
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 1:291 E 3RD ST
Mailing Address - Street 2:APT. 4B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10009-9703
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:291 E 3RD ST
Practice Address - Street 2:APT. 4B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10009-9703
Practice Address - Country:US
Practice Address - Phone:901-481-5165
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-13
Last Update Date:2009-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY054104122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist