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General NPI Number Information
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NPI Number | 1477437424
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Entity Type | Individual
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Provider Name | SHIVANGI NAYAN PATEL
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Gender | Female
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Dates
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Enumeration Date | 08/04/2025
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Last Update Date | 08/04/2025
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Provider Practice Location Address
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Address Line | 1601 E BAY DR STE 1
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City | LARGO
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State | FL
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Zip | 33771-5616
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Country | US
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Telephone | 727-585-5675
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Fax |
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Provider Business Mailing Address
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Address Line | 602 BRIGADOON DR
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City | CLEARWATER
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State | FL
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Zip | 33759-2949
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Country | US
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Telephone | 860-865-9602
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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 | 125J00000X
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Taxonomy Name | Dental Therapist
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License Number | DN30369
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License Number State | FL
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