Healthcare Provider Details

I. General information

NPI: 1134738404
Provider Name (Legal Business Name): AEKTA PATEL DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/23/2020
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11902 GREY PARTRIDGE DR
CHARLOTTE NC
28278-0084
US

IV. Provider business mailing address

11902 GREY PARTRIDGE DR
CHARLOTTE NC
28278-0084
US

V. Phone/Fax

Practice location:
  • Phone: 732-763-1627
  • Fax:
Mailing address:
  • Phone: 732-763-1627
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License NumberDN25515
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number10026
License Number StateSC
# 3
Primary TaxonomyN
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number12981
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: