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General NPI Number Information
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NPI Number | 1538652417
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Entity Type | Individual
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Provider Name | DUSAYANT PATEL DMD
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Gender | Male
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Dates
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Enumeration Date | 06/14/2018
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Last Update Date | 01/16/2026
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Provider Practice Location Address
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Address Line | 14090 FRYELANDS BLVD SE STE 348
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City | MONROE
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State | WA
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Zip | 98272-2760
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Country | US
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Telephone | 360-863-8700
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Fax |
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Provider Business Mailing Address
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Address Line | 1322 194TH ST SE APT F2
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City | BOTHELL
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State | WA
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Zip | 98012-8284
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Country | US
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Telephone | 832-830-4599
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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 | DENT.DE.70059199
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License Number State | WA
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