Individual
SHIVANI PATEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
1001 WIDEWATERS PKWY STE B, KNIGHTDALE, NC 27545-6103
(678) 386-1858
Mailing address
5280 SANDYFORD ST, ALEXANDRIA, VA 22315-5555
(678) 386-1858
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
0401415522
VA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
13631
NC
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
16583
MD
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
DN014925
GA
Other
Enumeration date
07/20/2015
Last updated
06/12/2024
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