=====================================================
General NPI Number Information
=====================================================
NPI Number | 1326451485
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DEVESH P PATEL D.M.D
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/06/2014
-----------------------------------------------------
Last Update Date | 10/31/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2527 DEKALB PIKE DR. J.C. PATEL AND ASSOCIATES PC
-----------------------------------------------------
City | NORRISTOWN
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19401-2034
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 610-272-3219
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1373 MEMORIAL DR
-----------------------------------------------------
City | WARWICK
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 18974-6136
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 215-900-0576
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 122300000X
-----------------------------------------------------
Taxonomy Name | Dentist
-----------------------------------------------------
License Number | DS039949
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------