Provider Demographics
NPI:1669417515
Name:PATIL-HOFFMAN, PRIYA M (DDS)
Entity type:Individual
Prefix:DR
First Name:PRIYA
Middle Name:M
Last Name:PATIL-HOFFMAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 S 101ST ST
Mailing Address - Street 2:APT #107
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68124-1085
Mailing Address - Country:US
Mailing Address - Phone:402-502-0279
Mailing Address - Fax:
Practice Address - Street 1:258 N 114TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68154-2515
Practice Address - Country:US
Practice Address - Phone:402-334-9239
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE63321223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice