Individual
SHIVANI PATEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
4753 VALLEY VIEW BLVD NW, ROANOKE, VA 24012-2004
(540) 682-7165
Mailing address
161 DEERWOOD TRL, STUART, VA 24171-1599
(276) 692-6706
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401418082
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/28/2021
Last updated
07/28/2022
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