Provider Demographics
NPI:1154878700
Name:PATEL, DHIR (DDS)
Entity type:Individual
Prefix:DR
First Name:DHIR
Middle Name:
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 1:63 SACRED PATH
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-8857
Mailing Address - Country:US
Mailing Address - Phone:951-532-4433
Mailing Address - Fax:
Practice Address - Street 1:2101 SW H K DODGEN LOOP
Practice Address - Street 2:SUITE 130
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76504
Practice Address - Country:US
Practice Address - Phone:254-265-8998
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-01
Last Update Date:2021-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA100675122300000X
MA18582461223G0001X
TX322951223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty
No122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice