Provider Demographics
NPI:1649337270
Name:PATEL, UPENDRA (DDS, INC)
Entity type:Individual
Prefix:DR
First Name:UPENDRA
Middle Name:
Last Name:PATEL
Suffix:
Gender:M
Credentials:DDS, INC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3960 EL CAMINO AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95821-6534
Mailing Address - Country:US
Mailing Address - Phone:415-690-6683
Mailing Address - Fax:
Practice Address - Street 1:3960 EL CAMINO AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95821-6534
Practice Address - Country:US
Practice Address - Phone:415-690-6683
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2014-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA53848122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist