Provider Demographics
NPI:1669811543
Name:PATEL, NISHABAHEN VIPULKUMAR (DDS)
Entity type:Individual
Prefix:
First Name:NISHABAHEN
Middle Name:VIPULKUMAR
Last Name:PATEL
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 1:17027 RYDAL GROVE LN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-1929
Mailing Address - Country:US
Mailing Address - Phone:586-365-8437
Mailing Address - Fax:
Practice Address - Street 1:13020 DAIRY ASHFORD RD STE 100
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-3151
Practice Address - Country:US
Practice Address - Phone:281-277-8571
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901021032122300000X
GADN0146921223G0001X
TX299121223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist