Healthcare Provider Details

I. General information

NPI: 1376467027
Provider Name (Legal Business Name): PRASHANT PATEL DDS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/06/2026
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1911 FALLS VALLEY DR STE 107
RALEIGH NC
27615-2496
US

IV. Provider business mailing address

5433 REBECCA LYNN LN
RALEIGH NC
27613-1070
US

V. Phone/Fax

Practice location:
  • Phone: 984-206-4242
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. PRASHANT PATEL
Title or Position: DENTIST
Credential: DDS
Phone: 580-236-9110