Provider Demographics
NPI:1871902254
Name:PATEL, HIMANSHU JANAKKUMAR (DMD)
Entity type:Individual
Prefix:
First Name:HIMANSHU
Middle Name:JANAKKUMAR
Last Name:PATEL
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10970 CHAPEL HILL RD STE 100
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-6238
Mailing Address - Country:US
Mailing Address - Phone:919-588-3000
Mailing Address - Fax:844-270-5383
Practice Address - Street 1:10970 CHAPEL HILL RD STE 100
Practice Address - Street 2:
Practice Address - City:MORRISVILLE
Practice Address - State:NC
Practice Address - Zip Code:27560-6238
Practice Address - Country:US
Practice Address - Phone:919-588-3000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-11
Last Update Date:2022-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12357122300000X
PADS0401231223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Yes122300000XDental ProvidersDentist