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General NPI Number Information
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NPI Number | 1669736880
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Entity Type | Individual
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Provider Name | DHRUVKUMAR JITENDRABHAI PATEL D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 07/03/2012
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Last Update Date | 03/01/2024
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Provider Practice Location Address
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Address Line | 966 N GARDEN RIDGE BLVD STE 510
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City | LEWISVILLE
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State | TX
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Zip | 75077-2876
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Country | US
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Telephone | 469-240-5590
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Fax | 469-240-5591
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Provider Business Mailing Address
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Address Line | 3316 CANYON LAKE DR
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City | LITTLE ELM
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State | TX
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Zip | 75068-2791
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Country | US
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Telephone | 714-404-5978
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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 | 30597
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 30597
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License Number State | TX
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