MEDICARE: DR. NIKITA 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	35099	TX

General Provider Information

NPI Number	:	1447868070
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NIKITA PATEL DMD

Provider Business Mailing Address
First Line	:	3912 ACAPULCO ST
Second Line	:
City	:	IRVING
State	:	TX
Zip	:	75062-6512
Country	:	US
Telephone Number	:	817-320-7493
Fax Number	:

Provider Business Practice Location Address
First Line	:	2240 MARKET PLACE BLVD STE 140
Second Line	:
City	:	IRVING
State	:	TX
Zip	:	75063-8098
Country	:	US
Telephone Number	:	972-534-6024
Fax Number	:

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

Provider Enumeration Date	:	07/20/2020
Last Update Date	:	07/20/2020

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