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General NPI Number Information
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NPI Number | 1578005872
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Entity Type | Individual
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Provider Name | TULSA PATIL DMD
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Gender | Female
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Dates
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Enumeration Date | 11/17/2016
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Last Update Date | 10/03/2025
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Provider Practice Location Address
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Address Line | 8725 DIGGES RD
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City | MANASSAS
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State | VA
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Zip | 20110-4403
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Country | US
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Telephone | 508-441-9521
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Fax |
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Provider Business Mailing Address
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Address Line | 3720 MAPLE HILL RD
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City | FAIRFAX
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State | VA
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Zip | 22033-2751
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Country | US
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Telephone | 508-441-9521
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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 | 1223D0004X
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Taxonomy Name | Dental Anesthesiology
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License Number | 0401419337
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 1223D0004X
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Taxonomy Name | Dental Anesthesiology
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License Number | DEN2001596
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License Number State | DC
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