Provider Demographics
NPI:1992908925
Name:PATEL, NIRALI NANDAN (DDS)
Entity type:Individual
Prefix:DR
First Name:NIRALI
Middle Name:NANDAN
Last Name:PATEL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:621 PECAN DRIVE
Mailing Address - Street 2:
Mailing Address - City:RIPON
Mailing Address - State:CA
Mailing Address - Zip Code:95366
Mailing Address - Country:US
Mailing Address - Phone:209-599-3550
Mailing Address - Fax:
Practice Address - Street 1:1710 E MARCH LN STE 2B
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95210-5665
Practice Address - Country:US
Practice Address - Phone:209-474-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA480151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice