Healthcare Provider Details

I. General information

NPI: 1295434918
Provider Name (Legal Business Name): MNALI PATEL DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/02/2023
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 ARCH ST STE 102
PHILADELPHIA PA
19103-1353
US

IV. Provider business mailing address

9309 VOITS LN
PHILADELPHIA PA
19115-4780
US

V. Phone/Fax

Practice location:
  • Phone: 215-515-2881
  • Fax: 267-715-5566
Mailing address:
  • Phone: 267-902-7933
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDS044544
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: