Provider Demographics
NPI:1336468941
Name:PATEL, DINESH NANDLAL (DDS)
Entity Type:Individual
Prefix:DR
First Name:DINESH
Middle Name:NANDLAL
Last Name:PATEL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9271 PEACH STREET
Mailing Address - Street 2:
Mailing Address - City:WATERFORD
Mailing Address - State:PA
Mailing Address - Zip Code:16441
Mailing Address - Country:US
Mailing Address - Phone:814-923-4510
Mailing Address - Fax:814-923-4199
Practice Address - Street 1:9271 PEACH STREET
Practice Address - Street 2:
Practice Address - City:WATERFORD
Practice Address - State:PA
Practice Address - Zip Code:16441
Practice Address - Country:US
Practice Address - Phone:814-923-4510
Practice Address - Fax:814-923-4199
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-21
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS038960122300000X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102661083Medicaid