Provider Demographics
NPI:1013064856
Name:PATEL, JAYENDRA B (DDS)
Entity type:Individual
Prefix:DR
First Name:JAYENDRA
Middle Name:B
Last Name:PATEL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8600 N MACARTHUR BLVD STE 140
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75063-3198
Mailing Address - Country:US
Mailing Address - Phone:972-869-9090
Mailing Address - Fax:972-869-9096
Practice Address - Street 1:8600 N MACARTHUR BLVD STE 140
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75063-3198
Practice Address - Country:US
Practice Address - Phone:972-869-9090
Practice Address - Fax:972-869-9096
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX217251223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice