Provider Demographics
NPI:1316685860
Name:PATEL, SHREYABEN T (DMD)
Entity type:Individual
Prefix:
First Name:SHREYABEN
Middle Name:T
Last Name:PATEL
Suffix:
Gender:
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77 WREXHAM RD
Mailing Address - Street 2:
Mailing Address - City:BRONXVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:10708-5810
Mailing Address - Country:US
Mailing Address - Phone:856-278-3986
Mailing Address - Fax:212-410-4424
Practice Address - Street 1:563 W 169TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-3912
Practice Address - Country:US
Practice Address - Phone:212-923-3375
Practice Address - Fax:646-253-1270
Is Sole Proprietor?:No
Enumeration Date:2022-05-24
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0634821223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice