Provider Demographics
NPI:1265984470
Name:PATIL, KARISHMA (BDS, MSD)
Entity type:Individual
Prefix:DR
First Name:KARISHMA
Middle Name:
Last Name:PATIL
Suffix:
Gender:F
Credentials:BDS, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4880 N PRESIDENT GEORGE BUSH HWY STE 102
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75040-2742
Mailing Address - Country:US
Mailing Address - Phone:972-496-0164
Mailing Address - Fax:972-295-9323
Practice Address - Street 1:5925 FOREST LN STE 314
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-2775
Practice Address - Country:US
Practice Address - Phone:469-416-7084
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-04
Last Update Date:2020-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX366871223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics