Provider Demographics
NPI:1770713232
Name:PATEL, ANUPAMA ARVIND (DDS)
Entity type:Individual
Prefix:DR
First Name:ANUPAMA
Middle Name:ARVIND
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 1:16 ARCADE UNIT 198747
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37219-1994
Mailing Address - Country:US
Mailing Address - Phone:615-753-0343
Mailing Address - Fax:615-986-1705
Practice Address - Street 1:14251 E 6TH AVE
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80011-8706
Practice Address - Country:US
Practice Address - Phone:303-343-3133
Practice Address - Fax:303-343-3139
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-19
Last Update Date:2013-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN9042122300000X
CODEN.002018421223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO2569781Medicaid