Healthcare Provider Details

I. General information

NPI: 1538038039
Provider Name (Legal Business Name): SHAHIL PATEL DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/03/2025
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1625 MCCALLIE AVE
CHATTANOOGA TN
37404-3022
US

IV. Provider business mailing address

116 BECKWOOD LN
MARYVILLE TN
37801-2966
US

V. Phone/Fax

Practice location:
  • Phone: 423-521-3550
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number12853
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: