Provider Demographics
NPI:1871832048
Name:PATEL, OHM MAHENDRA (DDS)
Entity Type:Individual
Prefix:DR
First Name:OHM
Middle Name:MAHENDRA
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 1:1124 GROGANS MILL DR
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27519-9472
Mailing Address - Country:US
Mailing Address - Phone:919-889-6595
Mailing Address - Fax:
Practice Address - Street 1:9660 FALLS OF NEUSE RD STE 153
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-2473
Practice Address - Country:US
Practice Address - Phone:919-322-3589
Practice Address - Fax:919-590-1933
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-08
Last Update Date:2019-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0573001223G0001X
NC10276122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice