Provider Demographics
NPI:1669886602
Name:PATEL, CHITRANG B (DMD)
Entity type:Individual
Prefix:DR
First Name:CHITRANG
Middle Name:B
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 1:158 WOOD ST UNIT 3
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01851-2107
Mailing Address - Country:US
Mailing Address - Phone:978-677-2114
Mailing Address - Fax:
Practice Address - Street 1:158 WOOD ST UNIT 3
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01851
Practice Address - Country:US
Practice Address - Phone:978-677-2114
Practice Address - Fax:978-677-2123
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-18
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN18565291223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice