Provider Demographics
NPI:1922678119
Name:PATEL, BRIANNA ATUL (DMD)
Entity Type:Individual
Prefix:DR
First Name:BRIANNA
Middle Name:ATUL
Last Name:PATEL
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5214 GOLDEN EAGLE TER
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33314-3904
Mailing Address - Country:US
Mailing Address - Phone:561-704-7784
Mailing Address - Fax:
Practice Address - Street 1:3041 PEACH ORCHARD RD
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30906-3505
Practice Address - Country:US
Practice Address - Phone:706-798-6720
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-29
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN258811223G0001X
GADN122337122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice