Provider Demographics
NPI:1447897533
Name:PATEL, DHAVAL GAURAV (DDS)
Entity type:Individual
Prefix:DR
First Name:DHAVAL
Middle Name:GAURAV
Last Name:PATEL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:623 CROSSING CRK S
Mailing Address - Street 2:
Mailing Address - City:GAHANNA
Mailing Address - State:OH
Mailing Address - Zip Code:43230-6114
Mailing Address - Country:US
Mailing Address - Phone:614-804-5190
Mailing Address - Fax:
Practice Address - Street 1:3264 E MAIN ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43213-2738
Practice Address - Country:US
Practice Address - Phone:614-236-1700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-08
Last Update Date:2019-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.0257871223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice