Provider Demographics
NPI:1053672451
Name:PATEL, GAURANG (DMD)
Entity type:Individual
Prefix:DR
First Name:GAURANG
Middle Name:
Last Name:PATEL
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7801 BEECHMONT AVE UNIT 5
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45255-4229
Mailing Address - Country:US
Mailing Address - Phone:513-954-0361
Mailing Address - Fax:
Practice Address - Street 1:7801 BEECHMONT AVE UNIT 5
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45255-4229
Practice Address - Country:US
Practice Address - Phone:513-954-0361
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-01
Last Update Date:2019-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.0237001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice