Provider Demographics
NPI:1386257822
Name:NIRJAL PATEL, DMD, P.A.
Entity type:Organization
Organization Name:NIRJAL PATEL, DMD, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NIRJAL
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:252-523-0544
Mailing Address - Street 1:1400 INDUSTRIAL DR
Mailing Address - Street 2:
Mailing Address - City:KINSTON
Mailing Address - State:NC
Mailing Address - Zip Code:28504-4500
Mailing Address - Country:US
Mailing Address - Phone:252-523-0544
Mailing Address - Fax:
Practice Address - Street 1:1400 INDUSTRIAL DR
Practice Address - Street 2:
Practice Address - City:KINSTON
Practice Address - State:NC
Practice Address - Zip Code:28504-4500
Practice Address - Country:US
Practice Address - Phone:252-523-0544
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-25
Last Update Date:2020-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty