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General NPI Number Information
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NPI Number | 1972278281
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Entity Type | Individual
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Provider Name | SHIVALI CHOPRA PATEL DDS
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Gender | Female
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Dates
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Enumeration Date | 08/10/2021
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Last Update Date | 09/29/2025
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Provider Practice Location Address
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Address Line | 1600 TRAVIS BLVD
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City | FAIRFIELD
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State | CA
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Zip | 94533-3429
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Country | US
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Telephone | 505-843-6060
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Fax | 505-255-0925
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Provider Business Mailing Address
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Address Line | 4255 WAGNER CT
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City | FAIRFIELD
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State | CA
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Zip | 94534-9630
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 111143
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License Number State | CA
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