Provider Demographics
NPI:1669690756
Name:PATEL, RAJENDRA H (DMD)
Entity type:Individual
Prefix:DR
First Name:RAJENDRA
Middle Name:H
Last Name:PATEL
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:974 INMAN AVE
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820-1177
Mailing Address - Country:US
Mailing Address - Phone:908-668-4500
Mailing Address - Fax:908-668-4501
Practice Address - Street 1:974 INMAN AVE
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820-1177
Practice Address - Country:US
Practice Address - Phone:908-668-4500
Practice Address - Fax:908-668-4501
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ144031223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice