Provider Demographics
NPI:1740286012
Name:PATEL, SAMIR ARVIND (DDS)
Entity type:Individual
Prefix:DR
First Name:SAMIR
Middle Name:ARVIND
Last Name:PATEL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 S TENNESSEE ST
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75069-5621
Mailing Address - Country:US
Mailing Address - Phone:972-542-3324
Mailing Address - Fax:972-542-4663
Practice Address - Street 1:401 S TENNESSEE ST
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75069-5621
Practice Address - Country:US
Practice Address - Phone:972-542-3324
Practice Address - Fax:972-542-3324
Is Sole Proprietor?:No
Enumeration Date:2005-06-22
Last Update Date:2009-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA447571223G0001X
TX205951223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice