=====================================================
General NPI Number Information
=====================================================
NPI Number | 1457239469
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | RISHI PATEL DMD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/26/2025
-----------------------------------------------------
Last Update Date | 08/26/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 150 MACDADE BLVD STE G
-----------------------------------------------------
City | DARBY
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19023-1814
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 610-583-2020
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 616 NESTING LN
-----------------------------------------------------
City | MIDDLETOWN
-----------------------------------------------------
State | DE
-----------------------------------------------------
Zip | 19709-6124
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 302-530-8342
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223G0001X
-----------------------------------------------------
Taxonomy Name | General Practice Dentistry
-----------------------------------------------------
License Number | DS045335
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------