Provider Demographics
NPI:1295272441
Name:PATEL, NISHI GARG (DMD, MS)
Entity type:Individual
Prefix:DR
First Name:NISHI
Middle Name:GARG
Last Name:PATEL
Suffix:
Gender:F
Credentials:DMD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:320 W 38TH ST APT 216
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10018-5215
Mailing Address - Country:US
Mailing Address - Phone:630-926-2422
Mailing Address - Fax:
Practice Address - Street 1:142 8TH AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-5108
Practice Address - Country:US
Practice Address - Phone:212-406-3686
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-26
Last Update Date:2024-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.0306391223X0400X
NY060642-011223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics