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NPI Code Detail

MEDICARE: BRINA V PATEL DMD

MEDICARE:   BRINA V PATEL  DMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentistDN 20753FL
21223G0001XGeneral Practice Dentistry13952NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1114335957
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRINA V PATEL DMD
Provider Business Mailing Address
First Line : 853 BEDMINISTER LN
Second Line :
City : WILMINGTON
State : NC
Zip : 28405-6238
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3901 OLEANDER DR
Second Line :
City : WILMINGTON
State : NC
Zip : 28403-6733
Country : US
Telephone Number : 910-859-7529
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/24/2014
Last Update Date : 11/19/2024

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