Healthcare Provider Details

I. General information

NPI: 1245628635
Provider Name (Legal Business Name): UMA PATEL DDS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/07/2015
Last Update Date: 01/07/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5021 MOWRY AVE
FREMONT CA
94538-1054
US

IV. Provider business mailing address

5021 MOWRY AVE
FREMONT CA
94538-1054
US

V. Phone/Fax

Practice location:
  • Phone: 510-797-4900
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. UMA PATEL
Title or Position: CEO
Credential:
Phone: 510-797-4900