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NPI Code Detail

MEDICARE: DR. DHRUVKUMAR JITENDRABHAI PATEL D.D.S.

MEDICARE: DR. DHRUVKUMAR JITENDRABHAI PATEL D.D.S.
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
11223G0001XGeneral Practice Dentistry30597TX
2122300000XDentist30597TX

General Provider Information

NPI Number : 1669736880
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DHRUVKUMAR JITENDRABHAI PATEL D.D.S.
Provider Business Mailing Address
First Line : 3316 CANYON LAKE DR
Second Line :
City : LITTLE ELM
State : TX
Zip : 75068-2791
Country : US
Telephone Number : 714-404-5978
Fax Number :
Provider Business Practice Location Address
First Line : 966 N GARDEN RIDGE BLVD STE 510
Second Line :
City : LEWISVILLE
State : TX
Zip : 75077-2876
Country : US
Telephone Number : 469-240-5590
Fax Number : 469-240-5591
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/03/2012
Last Update Date : 03/01/2024

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