Healthcare Provider Details

I. General information

NPI: 1801711866
Provider Name (Legal Business Name): AAGNA ASHUTOSH PATEL DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1717 JEFFERSON ST
BLUEFIELD WV
24701-4013
US

IV. Provider business mailing address

1717 JEFFERSON ST
BLUEFIELD WV
24701-4013
US

V. Phone/Fax

Practice location:
  • Phone: 304-327-2471
  • Fax:
Mailing address:
  • Phone: 304-327-2471
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number4891
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: