Provider Demographics
NPI:1427565704
Name:HIREN PATEL D.M.D. II, PA
Entity type:Organization
Organization Name:HIREN PATEL D.M.D. II, PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HIREN
Authorized Official - Middle Name:N
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:704-844-2943
Mailing Address - Street 1:8824 KENTUCKY DERBY DR
Mailing Address - Street 2:
Mailing Address - City:WAXHAW
Mailing Address - State:NC
Mailing Address - Zip Code:28173-6599
Mailing Address - Country:US
Mailing Address - Phone:704-941-5932
Mailing Address - Fax:
Practice Address - Street 1:2925 MATTHEWS WEDDINGTON ROAD
Practice Address - Street 2:SUITE 200
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28104
Practice Address - Country:US
Practice Address - Phone:704-844-2943
Practice Address - Fax:704-844-6205
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-08
Last Update Date:2018-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7923261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental