Provider Demographics
NPI:1952095861
Name:PATEL, VIDHI NIKHIL (DDS)
Entity Type:Individual
Prefix:
First Name:VIDHI
Middle Name:NIKHIL
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 1:143 MURRAY DR
Mailing Address - Street 2:
Mailing Address - City:OLD BRIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:08857-4205
Mailing Address - Country:US
Mailing Address - Phone:631-944-2470
Mailing Address - Fax:
Practice Address - Street 1:758 ROUTE 46
Practice Address - Street 2:
Practice Address - City:PARSIPPANY
Practice Address - State:NJ
Practice Address - Zip Code:07054-3401
Practice Address - Country:US
Practice Address - Phone:973-263-1770
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-05
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS044130122300000X
NJ220103007800122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist