Provider Demographics
NPI:1649685637
Name:PATEL, NIRAJ PRADIP (DDS)
Entity type:Individual
Prefix:DR
First Name:NIRAJ
Middle Name:PRADIP
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 1:1311 S MAIN ST STE 203
Mailing Address - Street 2:
Mailing Address - City:MOUNT AIRY
Mailing Address - State:MD
Mailing Address - Zip Code:21771-5457
Mailing Address - Country:US
Mailing Address - Phone:301-829-6550
Mailing Address - Fax:
Practice Address - Street 1:1311 S MAIN ST STE 203
Practice Address - Street 2:
Practice Address - City:MOUNT AIRY
Practice Address - State:MD
Practice Address - Zip Code:21771-5457
Practice Address - Country:US
Practice Address - Phone:301-829-6550
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-27
Last Update Date:2020-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD15454122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist