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General NPI Number Information
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NPI Number | 1699323618
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Entity Type | Individual
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Provider Name | JAYMIN JAYANTIBHAI PATEL BDS
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Gender | Male
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Dates
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Enumeration Date | 09/03/2019
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Last Update Date | 05/13/2024
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Provider Practice Location Address
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Address Line | 763 E US HIGHWAY 80 STE 210
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City | FORNEY
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State | TX
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Zip | 75126-8681
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Country | US
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Telephone | 972-268-8868
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Fax |
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Provider Business Mailing Address
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Address Line | 4030 N CENTRAL EXPY APT 342
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City | DALLAS
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State | TX
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Zip | 75204-3250
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Country | US
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Telephone | 213-327-7876
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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 | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 35700
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License Number State | TX
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