Provider Demographics
NPI:1336964642
Name:KHUSHBU N PATEL DDS PLLC
Entity type:Organization
Organization Name:KHUSHBU N PATEL DDS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KHUSHBU
Authorized Official - Middle Name:NISIT
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:205-356-3567
Mailing Address - Street 1:16131 ALSACE DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28278-8344
Mailing Address - Country:US
Mailing Address - Phone:205-356-3567
Mailing Address - Fax:
Practice Address - Street 1:1900 WELLNESS BLVD STE 104
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NC
Practice Address - Zip Code:28110-7763
Practice Address - Country:US
Practice Address - Phone:704-296-5100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-21
Last Update Date:2024-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental