Provider Demographics
NPI:1013656248
Name:PATEL, ZALAK TIRTH (DMD)
Entity Type:Individual
Prefix:
First Name:ZALAK
Middle Name:TIRTH
Last Name:PATEL
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:ZALAKBEN
Other - Middle Name:TIRTH
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:2453 SUSQUEHANNA RD
Mailing Address - Street 2:
Mailing Address - City:ABINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:19001-4208
Mailing Address - Country:US
Mailing Address - Phone:267-788-9944
Mailing Address - Fax:
Practice Address - Street 1:9301 BANES ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19115-4201
Practice Address - Country:US
Practice Address - Phone:215-709-0001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-04
Last Update Date:2022-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS043599122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist