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General NPI Number Information
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NPI Number | 1558684159
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Entity Type | Individual
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Provider Name | MOHIT H PATEL D.D.S
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Gender | Male
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Dates
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Enumeration Date | 03/10/2010
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Last Update Date | 09/11/2019
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Provider Practice Location Address
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Address Line | 24815 88TH RD
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City | BELLEROSE
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State | NY
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Zip | 11426-2005
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Country | US
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Telephone | 918-861-1439
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Fax |
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Provider Business Mailing Address
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Address Line | 24815 88TH RD
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City | BELLEROSE
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State | NY
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Zip | 11426-2005
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Country | US
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Telephone | 918-861-1439
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 010198
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 056558
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License Number State | NY
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