Healthcare Provider Details

I. General information

NPI: 1639012826
Provider Name (Legal Business Name): SILVER BEACH DENTAL PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2026
Last Update Date: 04/13/2026
Certification Date: 04/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3386 NILES RD
SAINT JOSEPH MI
49085-8800
US

IV. Provider business mailing address

7721 CROOKED COVE ST
KALAMAZOO MI
49009-4072
US

V. Phone/Fax

Practice location:
  • Phone: 269-348-5758
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: NILAY PATEL
Title or Position: MEMBER
Credential: DDS
Phone: 269-348-5758