Healthcare Provider Details

I. General information

NPI: 1962276618
Provider Name (Legal Business Name): SERENA ALKA PATEL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/13/2023
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 WHEELER RD UNIT F
BURLINGTON MA
01803-5293
US

IV. Provider business mailing address

1 WHEELER RD UNIT F
BURLINGTON MA
01803-5293
US

V. Phone/Fax

Practice location:
  • Phone: 781-552-3365
  • Fax:
Mailing address:
  • Phone: 781-552-3365
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN10001006
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: