Provider Demographics
NPI:1831451988
Name:PATEL, ANISHA DIPEN (DDS)
Entity type:Individual
Prefix:DR
First Name:ANISHA
Middle Name:DIPEN
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 1:1131 PROFESSIONAL DR
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23185-3329
Mailing Address - Country:US
Mailing Address - Phone:757-220-0330
Mailing Address - Fax:
Practice Address - Street 1:1131 PROFESSIONAL DR
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23185-3329
Practice Address - Country:US
Practice Address - Phone:757-220-0330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-14
Last Update Date:2012-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014136401223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice