Provider Demographics
NPI:1700172509
Name:PATEL, PRIYA (DDS)
Entity Type:Individual
Prefix:
First Name:PRIYA
Middle Name:
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 1:10230 NEW HAMPSHIRE AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20903-1422
Mailing Address - Country:US
Mailing Address - Phone:301-445-5821
Mailing Address - Fax:
Practice Address - Street 1:601 LIBRARY PARK DR STE B-1
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46142-1562
Practice Address - Country:US
Practice Address - Phone:317-881-2050
Practice Address - Fax:317-885-7485
Is Sole Proprietor?:No
Enumeration Date:2011-06-21
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD156001223G0001X
IN12011639A122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice