Healthcare Provider Details

I. General information

NPI: 1801728159
Provider Name (Legal Business Name): ABHILASHA SARJERAO PATIL BDS,MDS.MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 N STONEWALL AVE APT 52
OKLAHOMA CITY OK
73117-2832
US

IV. Provider business mailing address

900 N STONEWALL AVE APT 52
OKLAHOMA CITY OK
73117-2832
US

V. Phone/Fax

Practice location:
  • Phone: 405-549-8616
  • Fax:
Mailing address:
  • Phone: 405-549-8616
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License NumberFE-113
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License NumberLDF260039
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: