Provider Demographics
NPI:1215937057
Name:PATEL, RUPANDE (DDS, MS)
Entity type:Individual
Prefix:
First Name:RUPANDE
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6513 PRESTON RD
Mailing Address - Street 2:STE 500
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-2688
Mailing Address - Country:US
Mailing Address - Phone:972-378-6762
Mailing Address - Fax:972-378-6771
Practice Address - Street 1:6513 PRESTON RD
Practice Address - Street 2:STE 500
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-2688
Practice Address - Country:US
Practice Address - Phone:972-378-6762
Practice Address - Fax:972-378-6771
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-22
Last Update Date:2014-09-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX167421223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1470957-02Medicaid