Provider Demographics
NPI:1184224008
Name:PATEL, NIRAVKUMAR KANUBHAI (DMD)
Entity type:Individual
Prefix:
First Name:NIRAVKUMAR
Middle Name:KANUBHAI
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 1:211 ROBERT MORRIS BLVD APT 211
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104-4589
Mailing Address - Country:US
Mailing Address - Phone:215-500-7448
Mailing Address - Fax:
Practice Address - Street 1:927 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:EMMAUS
Practice Address - State:PA
Practice Address - Zip Code:18049-2021
Practice Address - Country:US
Practice Address - Phone:610-965-2755
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-29
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS042952122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist