MEDICARE: DR. LOKEN MUKESH PATEL D.M.D

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	1223E0200X	Endodontics	0401412185	VA

General Provider Information

NPI Number	:	1568449726
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LOKEN MUKESH PATEL D.M.D

Provider Business Mailing Address
First Line	:	4660 KENMORE AVE
Second Line	:	SUITE 700
City	:	ALEXANDRIA
State	:	VA
Zip	:	22304-1313
Country	:	US
Telephone Number	:	202-679-0315
Fax Number	:

Provider Business Practice Location Address
First Line	:	4660 KENMORE AVE
Second Line	:	SUITE 700
City	:	ALEXANDRIA
State	:	VA
Zip	:	22304-1313
Country	:	US
Telephone Number	:	202-679-0315
Fax Number	:

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

Provider Enumeration Date	:	12/29/2005
Last Update Date	:	08/27/2015

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