Provider Demographics
NPI:1982088126
Name:PATEL, KHUSHBU N (DDS)
Entity type:Individual
Prefix:DR
First Name:KHUSHBU
Middle Name:N
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 1:16131 ALSACE DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28278-8344
Mailing Address - Country:US
Mailing Address - Phone:205-356-3567
Mailing Address - Fax:
Practice Address - Street 1:4008 E FRANKLIN BLVD STE 100
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28056-8537
Practice Address - Country:US
Practice Address - Phone:704-816-0649
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-17
Last Update Date:2024-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0405331223G0001X
NC102521223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice