Provider Demographics
NPI:1710402250
Name:PATEL, HETVI (DDS)
Entity type:Individual
Prefix:
First Name:HETVI
Middle Name:
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 1:3466 GREAT BANYAN WAY
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33543-4141
Mailing Address - Country:US
Mailing Address - Phone:302-766-7200
Mailing Address - Fax:
Practice Address - Street 1:4424 FRIENDLY WAY
Practice Address - Street 2:SUITE 140
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33453
Practice Address - Country:US
Practice Address - Phone:813-798-3384
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-06
Last Update Date:2024-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN265081223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice