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General NPI Number Information
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NPI Number | 1790178770
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Entity Type | Individual
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Provider Name | DHARA PATEL DMD
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Gender | Female
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Dates
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Enumeration Date | 03/14/2015
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Last Update Date | 08/29/2020
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Provider Practice Location Address
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Address Line | 626 CHESTNUT ST
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City | UNION
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State | NJ
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Zip | 07083-9399
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Country | US
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Telephone | 908-688-1039
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Fax |
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Provider Business Mailing Address
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Address Line | 13 FAR KNOLL LN
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City | WHITEHOUSE STATION
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State | NJ
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Zip | 08889-3422
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Country | US
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Telephone | 610-506-5125
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Fax | 609-252-9007
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 026330
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 22DI02633000
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License Number State | NJ
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