Provider Demographics
NPI:1053401638
Name:PATEL, MEENAKSHI (DMD)
Entity type:Individual
Prefix:
First Name:MEENAKSHI
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:674 N CEDAR ST APT A
Mailing Address - Street 2:
Mailing Address - City:ELKO
Mailing Address - State:NV
Mailing Address - Zip Code:89801-2991
Mailing Address - Country:US
Mailing Address - Phone:775-777-3737
Mailing Address - Fax:775-777-3738
Practice Address - Street 1:674 N CEDAR ST APT A
Practice Address - Street 2:
Practice Address - City:ELKO
Practice Address - State:NV
Practice Address - Zip Code:89801-2991
Practice Address - Country:US
Practice Address - Phone:775-777-3737
Practice Address - Fax:775-777-3738
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2014-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV4646T1223G0001X
NV4646122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1053401638Medicaid
NV4646OtherNV DENTAL LICENSE