Provider Demographics
NPI:1831765908
Name:PATEL, AMITA HARIKRISHNA (DMD)
Entity type:Individual
Prefix:DR
First Name:AMITA
Middle Name:HARIKRISHNA
Last Name:PATEL
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:422 PYKE RD APT 422.5
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40504-2629
Mailing Address - Country:US
Mailing Address - Phone:606-307-1519
Mailing Address - Fax:
Practice Address - Street 1:7668 MALL RD UNIT B
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-1593
Practice Address - Country:US
Practice Address - Phone:859-568-1900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-31
Last Update Date:2021-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY10628122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist