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General NPI Number Information
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NPI Number | 1134827512
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Entity Type | Individual
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Provider Name | SHRUTI PATEL DDS
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Gender | Female
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Dates
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Enumeration Date | 02/16/2023
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Last Update Date | 10/14/2025
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Provider Practice Location Address
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Address Line | 150 RIVER RD STE H2
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City | MONTVILLE
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State | NJ
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Zip | 07045-8922
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Country | US
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Telephone | 973-917-3330
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Fax |
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Provider Business Mailing Address
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Address Line | 1300 AVENUE AT PORT IMPERIAL APT 439
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City | WEEHAWKEN
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State | NJ
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Zip | 07086-6967
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Country | US
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Telephone | 908-391-4085
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 22DI03064000
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License Number State | NJ
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