Healthcare Provider Details

I. General information

NPI: 1952783136
Provider Name (Legal Business Name): DR. ROSHNI PATEL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2015
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 S HICKORY ST
ESCONDIDO CA
92025-3354
US

IV. Provider business mailing address

140 S HICKORY ST
ESCONDIDO CA
92025-3354
US

V. Phone/Fax

Practice location:
  • Phone: 760-743-1896
  • Fax: 866-483-9860
Mailing address:
  • Phone: 760-743-1896
  • Fax: 866-483-9860

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number64578
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: