Provider Demographics
NPI:1992431530
Name:PATEL, DHVANI
Entity type:Individual
Prefix:DR
First Name:DHVANI
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:DHVANI
Other - Middle Name:
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DMD
Mailing Address - Street 1:4115 GALA CT
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:TX
Mailing Address - Zip Code:77477-4648
Mailing Address - Country:US
Mailing Address - Phone:832-279-1171
Mailing Address - Fax:
Practice Address - Street 1:20310 FM 529 RD STE 400
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77433-7786
Practice Address - Country:US
Practice Address - Phone:281-200-4000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-26
Last Update Date:2022-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX387661223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty