Provider Demographics
NPI:1699515874
Name:PATEL, NILANG PRAKASH (DMD)
Entity type:Individual
Prefix:
First Name:NILANG
Middle Name:PRAKASH
Last Name:PATEL
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:NILANG
Other - Middle Name:P
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:7644 263RD ST
Mailing Address - Street 2:
Mailing Address - City:FLORAL PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11004-1143
Mailing Address - Country:US
Mailing Address - Phone:646-704-4428
Mailing Address - Fax:
Practice Address - Street 1:7644 263RD ST
Practice Address - Street 2:
Practice Address - City:FLORAL PARK
Practice Address - State:NY
Practice Address - Zip Code:11004-1143
Practice Address - Country:US
Practice Address - Phone:646-704-4428
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-28
Last Update Date:2024-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.0276691223G0001X
390200000X
MADN100003631223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program