Provider Demographics
NPI:1851723472
Name:PATEL, MILI R (DDS)
Entity Type:Individual
Prefix:DR
First Name:MILI
Middle Name:R
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 1:4305 VIRTUOSO
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92620-0353
Mailing Address - Country:US
Mailing Address - Phone:646-306-6453
Mailing Address - Fax:
Practice Address - Street 1:17010 RED HILL AVE # D
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92614-5626
Practice Address - Country:US
Practice Address - Phone:646-306-6453
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-06
Last Update Date:2016-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD99231223G0001X
CA632151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice