Provider Demographics
NPI:1932394806
Name:PATEL, SHEFALI V (DMD)
Entity Type:Individual
Prefix:
First Name:SHEFALI
Middle Name:V
Last Name:PATEL
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1240 BORDER AVE
Mailing Address - Street 2:SUITE B-2
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92882-3801
Mailing Address - Country:US
Mailing Address - Phone:951-595-8007
Mailing Address - Fax:951-595-8007
Practice Address - Street 1:1035 W RAMSEY ST
Practice Address - Street 2:SUITE B-2
Practice Address - City:BANNING
Practice Address - State:CA
Practice Address - Zip Code:92220-4400
Practice Address - Country:US
Practice Address - Phone:714-322-5021
Practice Address - Fax:714-398-8026
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-12
Last Update Date:2016-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA562401223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice