Provider Demographics
NPI:1124113055
Name:PATEL, JAI VALLABH (DDS)
Entity type:Individual
Prefix:DR
First Name:JAI
Middle Name:VALLABH
Last Name:PATEL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:3000 SILVERLAKE VILLAGE DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-8419
Mailing Address - Country:US
Mailing Address - Phone:713-436-9959
Mailing Address - Fax:713-436-9968
Practice Address - Street 1:3000 SILVERLAKE VILLAGE DR
Practice Address - Street 2:SUITE 100
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-8419
Practice Address - Country:US
Practice Address - Phone:713-436-9959
Practice Address - Fax:713-436-9968
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2012-11-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX205081223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice