MEDICARE: SHILPA PATEL DDS

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	6945	AZ

General Provider Information

NPI Number	:	1396832614
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHILPA PATEL DDS

Provider Business Mailing Address
First Line	:	4159 W THUNDERBIRD RD
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85053-5341
Country	:	US
Telephone Number	:	602-938-1312
Fax Number	:	602-863-6655

Provider Business Practice Location Address
First Line	:	4159 W THUNDERBIRD RD
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85053-5341
Country	:	US
Telephone Number	:	602-938-1312
Fax Number	:	602-863-6655

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

Provider Enumeration Date	:	10/06/2006
Last Update Date	:	07/08/2007

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