Healthcare Provider Details

I. General information

NPI: 1194619494
Provider Name (Legal Business Name): VEDANSIBAHEN PATEL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2025
Last Update Date: 06/03/2025
Certification Date: 06/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

549 PARKVIEW DR
NEW WHITELAND IN
46184-1365
US

IV. Provider business mailing address

2227 MICHIGAN RD APT 1
MADISON IN
47250-2401
US

V. Phone/Fax

Practice location:
  • Phone: 317-680-5559
  • Fax:
Mailing address:
  • Phone: 732-371-7181
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number12014716A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: