Healthcare Provider Details

I. General information

NPI: 1053871186
Provider Name (Legal Business Name): UTSAV RAJESH PATEL DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/24/2019
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24 HOSPITAL AVE
DANBURY CT
06810-6099
US

IV. Provider business mailing address

510 E 23RD ST APT 13H
NEW YORK NY
10010-5016
US

V. Phone/Fax

Practice location:
  • Phone: 203-739-1555
  • Fax:
Mailing address:
  • Phone: 631-521-3050
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number061309
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: