Provider Demographics
NPI:1841882313
Name:PATEL, BANSARI HARDIK (DDS)
Entity type:Individual
Prefix:DR
First Name:BANSARI
Middle Name:HARDIK
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 1:3724 APPLEWOOD RD
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23234-4823
Mailing Address - Country:US
Mailing Address - Phone:804-588-8391
Mailing Address - Fax:
Practice Address - Street 1:10611 GREENYARD WAY STE A
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:VA
Practice Address - Zip Code:23831-1484
Practice Address - Country:US
Practice Address - Phone:804-717-2099
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-06
Last Update Date:2021-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401417331122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist