MEDICARE: SRUSHTI PATEL

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	122300000X	Dentist	DS045670	PA

General Provider Information

NPI Number	:	1164389482
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SRUSHTI PATEL

Provider Business Mailing Address
First Line	:	3867 UNION DEPOSIT RD
Second Line	:
City	:	HARRISBURG
State	:	PA
Zip	:	17109-5920
Country	:	US
Telephone Number	:	551-325-9690
Fax Number	:

Provider Business Practice Location Address
First Line	:	3867 UNION DEPOSIT RD
Second Line	:
City	:	HARRISBURG
State	:	PA
Zip	:	17109-5920
Country	:	US
Telephone Number	:	551-325-9690
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/07/2026
Last Update Date	:	05/19/2026

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Directions to “ SRUSHTI PATEL ” Practice Location

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