Provider Demographics
NPI:1922147180
Name:PATEL, AMITESH (DDS)
Entity Type:Individual
Prefix:
First Name:AMITESH
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 1:2430 STEINER ST
Mailing Address - Street 2:APT 9
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-1770
Mailing Address - Country:US
Mailing Address - Phone:415-674-7609
Mailing Address - Fax:
Practice Address - Street 1:1807 SANTA RITA RD
Practice Address - Street 2:STE C
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94566-4779
Practice Address - Country:US
Practice Address - Phone:925-846-6308
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2008-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA538471223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice