Healthcare Provider Details

I. General information

NPI: 1023219581
Provider Name (Legal Business Name): CHANGELA AND PATEL DDS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/30/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

345 S EUCLID ST SUITE A
FULLERTON CA
92832-2122
US

IV. Provider business mailing address

345 S EUCLID ST SUITE A
FULLERTON CA
92832-2122
US

V. Phone/Fax

Practice location:
  • Phone: 714-773-7300
  • Fax: 714-451-0011
Mailing address:
  • Phone: 714-773-7300
  • Fax: 714-451-0011

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number43182
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number49487
License Number StateCA

VIII. Authorized Official

Name: DR. BHAVIN CHANGELA
Title or Position: PRESIDENT
Credential: DDS
Phone: 714-773-9300