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General NPI Number Information
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NPI Number | 1881262319
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Entity Type | Individual
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Provider Name | JAI DEV DHIRENDRA PATEL DDS
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Gender | Male
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Dates
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Enumeration Date | 06/11/2021
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Last Update Date | 06/11/2021
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Provider Practice Location Address
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Address Line | 8015 TURKEY LAKE RD STE 300
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City | ORLANDO
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State | FL
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Zip | 32819-7383
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Country | US
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Telephone | 407-205-0246
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Fax |
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Provider Business Mailing Address
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Address Line | 4412 CLEAR RIVER CT
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City | ORLANDO
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State | FL
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Zip | 32817-1431
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Country | US
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Telephone | 407-497-6581
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | DN25942
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License Number State | FL
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