Healthcare Provider Details

I. General information

NPI: 1164420626
Provider Name (Legal Business Name): KAMLESH G. PATEL, D.M.D. P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2005
Last Update Date: 04/29/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2415 MUSGROVE RD SUITE 104
SILVER SPRING MD
20904-5224
US

IV. Provider business mailing address

2415 MUSGROVE RD SUITE 104
SILVER SPRING MD
20904-5200
US

V. Phone/Fax

Practice location:
  • Phone: 301-879-9500
  • Fax:
Mailing address:
  • Phone: 301-879-9500
  • 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. KAMLESH G PATEL
Title or Position: PRESIDENT
Credential: D.M.D.
Phone: 301-879-9500