Provider Demographics
NPI:1154982676
Name:DEVANI, HITESHKUMAR (DMD)
Entity type:Individual
Prefix:DR
First Name:HITESHKUMAR
Middle Name:
Last Name:DEVANI
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6105 N MAJOR DR APT 925
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77713-4232
Mailing Address - Country:US
Mailing Address - Phone:972-513-3563
Mailing Address - Fax:
Practice Address - Street 1:681 S MAIN ST
Practice Address - Street 2:
Practice Address - City:LUMBERTON
Practice Address - State:TX
Practice Address - Zip Code:77657
Practice Address - Country:US
Practice Address - Phone:409-227-0254
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-25
Last Update Date:2019-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX35364122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist