Provider Demographics
NPI:1942556196
Name:PATEL, PAYAL BHARATKUMAR (DDS)
Entity Type:Individual
Prefix:
First Name:PAYAL
Middle Name:BHARATKUMAR
Last Name:PATEL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4807 MAPLE AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75219-1006
Mailing Address - Country:US
Mailing Address - Phone:214-431-3727
Mailing Address - Fax:214-635-3803
Practice Address - Street 1:4807 MAPLE AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75219-1006
Practice Address - Country:US
Practice Address - Phone:214-431-3727
Practice Address - Fax:214-635-3803
Is Sole Proprietor?:No
Enumeration Date:2012-07-25
Last Update Date:2012-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX28178122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice