Provider Demographics
NPI:1902257322
Name:PATEL, BRIJESH (DMD)
Entity Type:Individual
Prefix:
First Name:BRIJESH
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 1:764 E THORNWOOD DR
Mailing Address - Street 2:
Mailing Address - City:SOUTH ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60177-3241
Mailing Address - Country:US
Mailing Address - Phone:630-656-2213
Mailing Address - Fax:
Practice Address - Street 1:2 WOODFIELD MALL
Practice Address - Street 2:
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173-5012
Practice Address - Country:US
Practice Address - Phone:847-619-0808
Practice Address - Fax:216-584-1009
Is Sole Proprietor?:No
Enumeration Date:2016-06-27
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.0307711223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice