Provider Demographics
NPI:1942949821
Name:PATEL, DEVANGKUMAR CHAMPAKBHAI (DMD)
Entity Type:Individual
Prefix:DR
First Name:DEVANGKUMAR
Middle Name:CHAMPAKBHAI
Last Name:PATEL
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1640 NICHOLASVILLE RD STE 203
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-1494
Mailing Address - Country:US
Mailing Address - Phone:859-317-9544
Mailing Address - Fax:
Practice Address - Street 1:1640 NICHOLASVILLE RD STE 203
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-1494
Practice Address - Country:US
Practice Address - Phone:859-317-9544
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-31
Last Update Date:2022-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY107621223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice