Provider Demographics
NPI:1699323618
Name:PATEL, JAYMIN JAYANTIBHAI (BDS)
Entity type:Individual
Prefix:
First Name:JAYMIN
Middle Name:JAYANTIBHAI
Last Name:PATEL
Suffix:
Gender:M
Credentials:BDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4030 N CENTRAL EXPY APT 342
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75204-3250
Mailing Address - Country:US
Mailing Address - Phone:213-327-7876
Mailing Address - Fax:
Practice Address - Street 1:763 E US HIGHWAY 80 STE 210
Practice Address - Street 2:
Practice Address - City:FORNEY
Practice Address - State:TX
Practice Address - Zip Code:75126-8681
Practice Address - Country:US
Practice Address - Phone:972-268-8868
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-03
Last Update Date:2024-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX357001223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics