Provider Demographics
NPI:1811329931
Name:PATEL, DARSHANKUMAR (DDS)
Entity type:Individual
Prefix:DR
First Name:DARSHANKUMAR
Middle Name:
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 1:11203 LAKE JUNE RD STE 120
Mailing Address - Street 2:
Mailing Address - City:BALCH SPRINGS
Mailing Address - State:TX
Mailing Address - Zip Code:75180-1219
Mailing Address - Country:US
Mailing Address - Phone:972-752-6210
Mailing Address - Fax:
Practice Address - Street 1:11203 LAKE JUNE RD SUITE 120
Practice Address - Street 2:
Practice Address - City:BALCH SPRINGS
Practice Address - State:TX
Practice Address - Zip Code:75160-2303
Practice Address - Country:US
Practice Address - Phone:972-752-6210
Practice Address - Fax:972-752-6210
Is Sole Proprietor?:No
Enumeration Date:2013-07-31
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX28914122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX322100403Medicaid