Provider Demographics
NPI:1770893760
Name:PATEL, NILAM TULSIDAS (DDS)
Entity type:Individual
Prefix:DR
First Name:NILAM
Middle Name:TULSIDAS
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 1:502 PRINCETON RD STE B
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37601-2047
Mailing Address - Country:US
Mailing Address - Phone:423-282-0042
Mailing Address - Fax:423-282-0042
Practice Address - Street 1:502 PRINCETON RD STE B
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37601-2047
Practice Address - Country:US
Practice Address - Phone:423-282-0042
Practice Address - Fax:423-282-0042
Is Sole Proprietor?:No
Enumeration Date:2010-10-08
Last Update Date:2010-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS 92091223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice