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NPI Code Detail

MEDICARE: DR. ASHUTOSH KIRITKUMAR PATEL DDS

MEDICARE: DR. ASHUTOSH KIRITKUMAR 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
11223G0001XGeneral Practice Dentistry1002625-15WI

General Provider Information

NPI Number : 1992479067
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ASHUTOSH KIRITKUMAR PATEL DDS
Provider Business Mailing Address
First Line : 382 ALLARD BLVD SW
Second Line :
City : EDMONTON
State : ALBERTA
Zip : T6W 3T7
Country : CA
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5341 W FOND DU LAC AVE
Second Line :
City : MILWAUKEE
State : WI
Zip : 53216-1365
Country : US
Telephone Number : 414-871-0827
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/03/2021
Last Update Date : 08/03/2021

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