Provider Demographics
NPI:1316271380
Name:PATEL, KUNAL (DDS)
Entity type:Individual
Prefix:DR
First Name:KUNAL
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 1:840 W BARTLETT RD
Mailing Address - Street 2:SUITE #1
Mailing Address - City:BARTLETT
Mailing Address - State:IL
Mailing Address - Zip Code:60103-4450
Mailing Address - Country:US
Mailing Address - Phone:630-837-1441
Mailing Address - Fax:
Practice Address - Street 1:840 W BARTLETT RD
Practice Address - Street 2:SUITE #1
Practice Address - City:BARTLETT
Practice Address - State:IL
Practice Address - Zip Code:60103-4450
Practice Address - Country:US
Practice Address - Phone:630-837-1441
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-23
Last Update Date:2011-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190279141223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice