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NPI Code Detail

MEDICARE: PRAMUKH DENTAL PRACTICE, PLLC

MEDICARE: PRAMUKH DENTAL PRACTICE, PLLC
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
11223G0001XGeneral Practice Dentistry

General Provider Information

NPI Number : 1306788278
Entity Type Code : Organization
Provider Name (Legal Business Name) : PRAMUKH DENTAL PRACTICE, PLLC
Provider Business Mailing Address
First Line : 19007 BRUCE B DOWNS BLVD
Second Line :
City : TAMPA
State : FL
Zip : 33647-2475
Country : US
Telephone Number : 813-406-4947
Fax Number : 813-406-4950
Provider Business Practice Location Address
First Line : 19007 BRUCE B DOWNS BLVD
Second Line :
City : TAMPA
State : FL
Zip : 33647-2475
Country : US
Telephone Number : 813-406-4947
Fax Number : 813-406-4950
Authorized Official
Title or Position : PRESIDENT
Name : VIJAY PATEL
Credential : DDS
Telephone Number : 813-406-4947
Provider Enumeration Date : 04/08/2026
Last Update Date : 04/08/2026

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Directions to “PRAMUKH DENTAL PRACTICE, PLLC ” Practice Location

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