Healthcare Provider Details

I. General information

NPI: 1780255745
Provider Name (Legal Business Name): SMINU D PATEL DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/09/2021
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 N BRIDGE ST
BRIDGEWATER NJ
08807-2135
US

IV. Provider business mailing address

25108 BARTON RD
LOMA LINDA CA
92354-2919
US

V. Phone/Fax

Practice location:
  • Phone: 908-252-4410
  • Fax:
Mailing address:
  • Phone: 973-533-8478
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number22DI03061900
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number106507
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: