Healthcare Provider Details

I. General information

NPI: 1770415077
Provider Name (Legal Business Name): TAMIAMI DENTAL CARE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4135 TAMIAMI TRL E
NAPLES FL
34112-6238
US

IV. Provider business mailing address

3121 NOVARA LN
BRADENTON FL
34211-3788
US

V. Phone/Fax

Practice location:
  • Phone: 678-975-8169
  • Fax:
Mailing address:
  • Phone: 678-975-8169
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VIII. Authorized Official

Name: KISHEN SATYAKAM PATEL
Title or Position: DENTIST
Credential: DDS
Phone: 678-975-8169