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General NPI Number Information
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NPI Number | 1881580165
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Entity Type | Individual
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Provider Name | HITARTH PATEL
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Gender | Male
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Dates
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Enumeration Date | 06/14/2025
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Last Update Date | 08/20/2025
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Provider Practice Location Address
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Address Line | 9601 MANCHESTER RD
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City | SAINT LOUIS
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State | MO
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Zip | 63119-1333
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Country | US
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Telephone | 331-308-3341
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Fax |
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Provider Business Mailing Address
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Address Line | 219 LILLIAN PL
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City | BARTLETT
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State | IL
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Zip | 60103-2315
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Country | US
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Telephone |
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 019.036240
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 2025021095
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License Number State | MO
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