Provider Demographics
NPI:1750390365
Name:PATEL, NILIMA M (DDS)
Entity type:Individual
Prefix:DR
First Name:NILIMA
Middle Name:M
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 1:1227 BUENA VISTA ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:DUARTE
Mailing Address - State:CA
Mailing Address - Zip Code:91010-2486
Mailing Address - Country:US
Mailing Address - Phone:626-358-2578
Mailing Address - Fax:626-359-2758
Practice Address - Street 1:1227 BUENA VISTA ST
Practice Address - Street 2:SUITE A
Practice Address - City:DUARTE
Practice Address - State:CA
Practice Address - Zip Code:91010-2486
Practice Address - Country:US
Practice Address - Phone:626-358-2578
Practice Address - Fax:626-359-2758
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADK371501223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice