Healthcare Provider Details

I. General information

NPI: 1609701077
Provider Name (Legal Business Name): PINAKIN PATEL
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2026
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2380 MERCHANT MILE
COLUMBUS IN
47201-1557
US

IV. Provider business mailing address

7250 RAYBOURN CT
INDIANAPOLIS IN
46259-1383
US

V. Phone/Fax

Practice location:
  • Phone: 812-378-5500
  • Fax:
Mailing address:
  • Phone: 917-912-0798
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number12015069A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: