MEDICARE: DR. BANSARI HARDIK 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	122300000X	Dentist	0401417331	VA

General Provider Information

NPI Number	:	1841882313
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BANSARI HARDIK PATEL DDS

Provider Business Mailing Address
First Line	:	3724 APPLEWOOD RD
Second Line	:
City	:	NORTH CHESTERFIELD
State	:	VA
Zip	:	23234-4823
Country	:	US
Telephone Number	:	804-588-8391
Fax Number	:

Provider Business Practice Location Address
First Line	:	10611 GREENYARD WAY STE A
Second Line	:
City	:	CHESTER
State	:	VA
Zip	:	23831-1484
Country	:	US
Telephone Number	:	804-717-2099
Fax Number	:

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

Provider Enumeration Date	:	02/06/2021
Last Update Date	:	02/06/2021

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