Provider Demographics
NPI:1912231663
Name:WEST COAST DENTAL PARTNERS
Entity Type:Organization
Organization Name:WEST COAST DENTAL PARTNERS
Other - Org Name:SMILE DESIGN DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:MILI
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:727-376-2666
Mailing Address - Street 1:4104 LITTLE RD
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34655-1721
Mailing Address - Country:US
Mailing Address - Phone:727-376-2666
Mailing Address - Fax:727-375-2577
Practice Address - Street 1:4104 LITTLE RD
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34655-1721
Practice Address - Country:US
Practice Address - Phone:727-376-2666
Practice Address - Fax:727-375-2577
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WEST COAST DENTAL PARTNERS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-09-29
Last Update Date:2019-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN159641223G0001X
FLDN154561223G0001X
FLDN174191223G0001X
332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Multi-Specialty