Healthcare Provider Details

I. General information

NPI: 1801704861
Provider Name (Legal Business Name): ESHAN PATEL
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

131 W ONTARIO AVE
CORONA CA
92882-5274
US

IV. Provider business mailing address

132 MILKY WAY
IRVINE CA
92618-8889
US

V. Phone/Fax

Practice location:
  • Phone: 951-898-9700
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDDS113617
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: