Provider Demographics
NPI:1508412875
Name:PATEL, KAMAL PARESH (DDS)
Entity Type:Individual
Prefix:DR
First Name:KAMAL
Middle Name:PARESH
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 1:112 BLACK HILL DR
Mailing Address - Street 2:
Mailing Address - City:STREAMWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60107-4502
Mailing Address - Country:US
Mailing Address - Phone:847-961-8381
Mailing Address - Fax:
Practice Address - Street 1:7565 W WASHINGTON AVE STE 101
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-4334
Practice Address - Country:US
Practice Address - Phone:702-342-8631
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-13
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190323401223G0001X
NV77361223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice