Provider Demographics
NPI:1174353684
Name:PATEL, HIMANI K (DDS)
Entity type:Individual
Prefix:DR
First Name:HIMANI
Middle Name:K
Last Name:PATEL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5128 HILLINGTON WAY
Mailing Address - Street 2:
Mailing Address - City:SUGAR HILL
Mailing Address - State:GA
Mailing Address - Zip Code:30518
Mailing Address - Country:US
Mailing Address - Phone:803-682-9773
Mailing Address - Fax:
Practice Address - Street 1:2000 RIVERSIDE PKWY STE 200
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30043-5926
Practice Address - Country:US
Practice Address - Phone:470-568-3862
Practice Address - Fax:678-442-0398
Is Sole Proprietor?:No
Enumeration Date:2024-08-07
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN1235391223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice