Provider Demographics
NPI:1316067283
Name:RITA V. PATEL DDS INC
Entity type:Organization
Organization Name:RITA V. PATEL DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RITA
Authorized Official - Middle Name:VISHNU
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:909-624-7222
Mailing Address - Street 1:9625 MONTE VISTA AVE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:MONTCLAIR
Mailing Address - State:CA
Mailing Address - Zip Code:91763-2234
Mailing Address - Country:US
Mailing Address - Phone:909-624-7222
Mailing Address - Fax:909-624-1893
Practice Address - Street 1:9625 MONTE VISTA AVE
Practice Address - Street 2:SUITE 104
Practice Address - City:MONTCLAIR
Practice Address - State:CA
Practice Address - Zip Code:91763-2234
Practice Address - Country:US
Practice Address - Phone:909-624-7222
Practice Address - Fax:909-624-1893
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA455151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty