Provider Demographics
NPI:1891859666
Name:PATEL, KIRIT RAMANBHAI (DDS)
Entity Type:Individual
Prefix:DR
First Name:KIRIT
Middle Name:RAMANBHAI
Last Name:PATEL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:34043 GOLDEN CROWN WAY
Mailing Address - Street 2:
Mailing Address - City:YUCAIPA
Mailing Address - State:CA
Mailing Address - Zip Code:92399-6966
Mailing Address - Country:US
Mailing Address - Phone:909-790-6035
Mailing Address - Fax:760-322-6518
Practice Address - Street 1:174 S SUNRISE WAY
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262-6737
Practice Address - Country:US
Practice Address - Phone:760-322-1002
Practice Address - Fax:760-322-6518
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2021-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA506671223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice