Provider Demographics
NPI:1134344609
Name:DRS. PATEL, ALSTON & ASSOCIATES I, P.A.
Entity type:Organization
Organization Name:DRS. PATEL, ALSTON & ASSOCIATES I, P.A.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:HARISH
Authorized Official - Middle Name:BHANUPRASAD
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:704-844-0556
Mailing Address - Street 1:PO BOX 860036
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55486-0036
Mailing Address - Country:US
Mailing Address - Phone:704-844-0556
Mailing Address - Fax:216-584-1103
Practice Address - Street 1:2335 MATTHEWS TWP PARKWAY
Practice Address - Street 2:SUITE #111
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105-2360
Practice Address - Country:US
Practice Address - Phone:704-844-0556
Practice Address - Fax:216-584-1103
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DENTALONE PARTNERS, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-04-17
Last Update Date:2014-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1223G0001X, 1223X0400X, 122300000X, 1223P0700X, 1223E0200X, 1223P0300X, 1223P0221X
NC68331223G0001X
NC83441223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
No1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty
No122300000XDental ProvidersDentistGroup - Single Specialty
No1223P0700XDental ProvidersDentistProsthodonticsGroup - Single Specialty
No1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty
No1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty
No1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty