MEDICARE: DR. MINESH Y PATEL D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	DS0000007245	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1225037963
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MINESH Y PATEL D.D.S.

Provider Business Mailing Address
First Line	:	7548 TAGG DR
Second Line	:
City	:	GERMANTOWN
State	:	TN
Zip	:	38138-5827
Country	:	US
Telephone Number	:	901-753-2958
Fax Number	:	731-424-9719

Provider Business Practice Location Address
First Line	:	1523 S HIGHLAND AVE
Second Line	:
City	:	JACKSON
State	:	TN
Zip	:	38301-7520
Country	:	US
Telephone Number	:	731-424-6452
Fax Number	:	731-424-9719

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/15/2005
Last Update Date	:	11/25/2024

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