Provider Demographics
NPI:1063580157
Name:PATEL, NIMESH NARESH (DDS)
Entity type:Individual
Prefix:DR
First Name:NIMESH
Middle Name:NARESH
Last Name:PATEL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:66 LAKESIDE DR
Mailing Address - Street 2:
Mailing Address - City:BUENA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90621-1648
Mailing Address - Country:US
Mailing Address - Phone:714-739-1740
Mailing Address - Fax:
Practice Address - Street 1:33 CREEK RD
Practice Address - Street 2:SUITE 210
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92604-4791
Practice Address - Country:US
Practice Address - Phone:949-857-6757
Practice Address - Fax:949-857-0791
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA529111223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice