Provider Demographics
NPI:1942396734
Name:PATEL, SHITAL (DDS)
Entity Type:Individual
Prefix:DR
First Name:SHITAL
Middle Name:
Last Name:PATEL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:260 E ONTARIO AVE
Mailing Address - Street 2:STE 201
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92879-3506
Mailing Address - Country:US
Mailing Address - Phone:951-898-8511
Mailing Address - Fax:951-898-8591
Practice Address - Street 1:1185 MAGNOLIA AVE
Practice Address - Street 2:SUITE K
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92879-3218
Practice Address - Country:US
Practice Address - Phone:951-898-8511
Practice Address - Fax:951-898-8591
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2015-06-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA453081223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice