Provider Demographics
NPI:1134738404
Name:PATEL, AEKTA (DDS)
Entity type:Individual
Prefix:DR
First Name:AEKTA
Middle Name:
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 1:11902 GREY PARTRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28278-4412
Mailing Address - Country:US
Mailing Address - Phone:732-763-1627
Mailing Address - Fax:
Practice Address - Street 1:2349 CHERRY RD STE 49
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-2132
Practice Address - Country:US
Practice Address - Phone:803-632-4597
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-23
Last Update Date:2023-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC100261223G0001X
FLDN255151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice