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General NPI Number Information
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NPI Number | 1033261284
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Entity Type | Individual
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Provider Name | NIRAV NANA PATEL D.D.S
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Gender | Male
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Dates
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Enumeration Date | 01/17/2007
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Last Update Date | 06/20/2014
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Provider Practice Location Address
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Address Line | 200 S WELLS RD # 200
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City | VENTURA
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State | CA
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Zip | 93004-1377
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Country | US
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Telephone | 714-603-4432
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Fax |
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Provider Business Mailing Address
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Address Line | 2361 S CUTTY WAY UNIT #64
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City | ANAHEIM
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State | CA
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Zip | 92802-3560
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Country | US
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Telephone | 714-603-4432
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 52910
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License Number State | CA
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