Provider Demographics
NPI:1669736880
Name:PATEL, DHRUVKUMAR JITENDRABHAI (DDS)
Entity type:Individual
Prefix:DR
First Name:DHRUVKUMAR
Middle Name:JITENDRABHAI
Last Name:PATEL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:DHRUVKUMAR
Other - Middle Name:JITENDRA
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:3316 CANYON LAKE DR
Mailing Address - Street 2:
Mailing Address - City:LITTLE ELM
Mailing Address - State:TX
Mailing Address - Zip Code:75068-2791
Mailing Address - Country:US
Mailing Address - Phone:714-404-5978
Mailing Address - Fax:
Practice Address - Street 1:966 N GARDEN RIDGE BLVD STE 510
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75077-2876
Practice Address - Country:US
Practice Address - Phone:469-240-5590
Practice Address - Fax:469-240-5591
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-03
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX305971223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist