Healthcare Provider Details

I. General information

NPI: 1720055270
Provider Name (Legal Business Name): SWATI PATEL DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/03/2006
Last Update Date: 08/20/2025
Certification Date: 08/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1852 N MASTICK WAY MARIPOSA COMMUNITY HEALTH CENTER
NOGALES AZ
85621-1063
US

IV. Provider business mailing address

825 N GRAND AVE SUITE 100
NOGALES AZ
85621
US

V. Phone/Fax

Practice location:
  • Phone: 520-281-1550
  • Fax: 520-281-1112
Mailing address:
  • Phone: 520-761-2128
  • Fax: 520-281-1112

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223D0001X
TaxonomyPublic Health Dentistry
License NumberD5828
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberD5828
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: