Provider Demographics
NPI:1891876272
Name:PATEL, SANJAY (DDS)
Entity Type:Individual
Prefix:DR
First Name:SANJAY
Middle Name:
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 1:538 BAILEY RD
Mailing Address - Street 2:
Mailing Address - City:BAY POINT
Mailing Address - State:CA
Mailing Address - Zip Code:94565-4304
Mailing Address - Country:US
Mailing Address - Phone:925-709-0200
Mailing Address - Fax:925-709-2040
Practice Address - Street 1:538 BAILEY RD
Practice Address - Street 2:
Practice Address - City:BAY POINT
Practice Address - State:CA
Practice Address - Zip Code:94565-4304
Practice Address - Country:US
Practice Address - Phone:925-709-0200
Practice Address - Fax:925-709-2040
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA38113122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist