MEDICARE: DR. KRUPAL V PATEL DMD

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	DN24364	FL

General Provider Information

NPI Number	:	1437700630
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KRUPAL V PATEL DMD

Provider Business Mailing Address
First Line	:	4837 TIGERTAIL CT
Second Line	:
City	:	NEW PORT RICHEY
State	:	FL
Zip	:	34653-6577
Country	:	US
Telephone Number	:	727-225-3620
Fax Number	:

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	:

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

Provider Enumeration Date	:	09/27/2019
Last Update Date	:	09/27/2019

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