Provider Demographics
NPI:1942066253
Name:PATEL COUNTY DENTISTRY PC
Entity Type:Organization
Organization Name:PATEL COUNTY DENTISTRY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NIMESH
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:DMD, MS
Authorized Official - Phone:614-975-4592
Mailing Address - Street 1:667 STONELEIGH AVE STE 207
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:NY
Mailing Address - Zip Code:10512-2455
Mailing Address - Country:US
Mailing Address - Phone:845-459-8500
Mailing Address - Fax:
Practice Address - Street 1:9475 DEERECO RD STE 204
Practice Address - Street 2:
Practice Address - City:TIMONIUM
Practice Address - State:MD
Practice Address - Zip Code:21093-2122
Practice Address - Country:US
Practice Address - Phone:614-975-4592
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-23
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty