=====================================================
General NPI Number Information
=====================================================
NPI Number | 1013729813
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SOLSMILE LOUNGE
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/21/2025
-----------------------------------------------------
Last Update Date | 01/21/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8905 REGENTS PARK DR STE 250
-----------------------------------------------------
City | TAMPA
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33647-3081
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 813-333-9192
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8905 REGENTS PARK DR STE 250
-----------------------------------------------------
City | TAMPA
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33647-3081
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 813-333-9192
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/DENTIST
-----------------------------------------------------
Name | MEGHA T PATEL
-----------------------------------------------------
Credential | DMD
-----------------------------------------------------
Telephone | 732-500-4916
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223G0001X
-----------------------------------------------------
Taxonomy Name | General Practice Dentistry
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------