Provider Demographics
NPI:1396951265
Name:PATEL, UMANG (DDS)
Entity type:Individual
Prefix:DR
First Name:UMANG
Middle Name:
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 1:638 N INDEPENDENCE BLVD
Mailing Address - Street 2:
Mailing Address - City:ROMEOVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60446-1374
Mailing Address - Country:US
Mailing Address - Phone:815-886-0875
Mailing Address - Fax:
Practice Address - Street 1:638 N INDEPENDENCE BLVD
Practice Address - Street 2:
Practice Address - City:ROMEOVILLE
Practice Address - State:IL
Practice Address - Zip Code:60446-1374
Practice Address - Country:US
Practice Address - Phone:815-886-0875
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.025420122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist