Healthcare Provider Details

I. General information

NPI: 1104762541
Provider Name (Legal Business Name): KARAN S PATEL DMD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7263 AVALON RD STE 121
WINTER GARDEN FL
34787-5890
US

IV. Provider business mailing address

15125 HAVENCREST CIR APT 5310
WINTER GARDEN FL
34787-7161
US

V. Phone/Fax

Practice location:
  • Phone: 321-890-8222
  • Fax:
Mailing address:
  • Phone: 321-890-8222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. KARAN SANGIV PATEL
Title or Position: OWNER AND ORTHODONTIST
Credential: DMD, MS
Phone: 321-890-8222