MEDICARE: TBP DENTAL PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1124952395
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TBP DENTAL PLLC

Provider Business Mailing Address
First Line	:	6 LAUREL LN
Second Line	:
City	:	OLD WESTBURY
State	:	NY
Zip	:	11568-1544
Country	:	US
Telephone Number	:	516-581-3605
Fax Number	:

Provider Business Practice Location Address
First Line	:	697 OLD COUNTRY ROAD
Second Line	:
City	:	DIX HILLS
State	:	NY
Zip	:	11746
Country	:	US
Telephone Number	:	631-629-1680
Fax Number	:

Authorized Official
Title or Position	:	DENTIST/OWNER
Name	:	DR. TEJAS PATEL
Credential	:	DDS
Telephone Number	:	516-581-3605

Provider Enumeration Date	:	06/11/2026
Last Update Date	:	06/11/2026

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