Provider Demographics
NPI:1528650462
Name:PATEL TRAUMA AND ORAL SURGERY LLC
Entity type:Organization
Organization Name:PATEL TRAUMA AND ORAL SURGERY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:NEEL
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD, DMD
Authorized Official - Phone:804-386-8719
Mailing Address - Street 1:5530 WISCONSIN AVE STE 930
Mailing Address - Street 2:
Mailing Address - City:CHEVY CHASE
Mailing Address - State:MD
Mailing Address - Zip Code:20815-4316
Mailing Address - Country:US
Mailing Address - Phone:804-386-8719
Mailing Address - Fax:
Practice Address - Street 1:5530 WISCONSIN AVE STE 930
Practice Address - Street 2:
Practice Address - City:CHEVY CHASE
Practice Address - State:MD
Practice Address - Zip Code:20815-4316
Practice Address - Country:US
Practice Address - Phone:804-386-8719
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-10
Last Update Date:2021-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial SurgeryGroup - Multi-Specialty
No2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma SurgeryGroup - Multi-Specialty