Provider Demographics
NPI:1477436723
Name:PATEL, BHUMIKA KIRANBHAI
Entity type:Individual
Prefix:
First Name:BHUMIKA
Middle Name:KIRANBHAI
Last Name:PATEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5564 LITTLE DEBBIE PKWY STE 120
Mailing Address - Street 2:
Mailing Address - City:OOLTEWAH
Mailing Address - State:TN
Mailing Address - Zip Code:37363-4333
Mailing Address - Country:US
Mailing Address - Phone:423-490-7676
Mailing Address - Fax:
Practice Address - Street 1:5564 LITTLE DEBBIE PKWY STE 120
Practice Address - Street 2:
Practice Address - City:OOLTEWAH
Practice Address - State:TN
Practice Address - Zip Code:37363-4333
Practice Address - Country:US
Practice Address - Phone:423-490-7676
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-25
Last Update Date:2025-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN12932122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist