MEDICARE: NIDHI BRIJESH PATEL DDS

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	DS044218	PA
2	122300000X	Dentist	12014389A	IN

General Provider Information

NPI Number	:	1285314955
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NIDHI BRIJESH PATEL DDS

Provider Business Mailing Address
First Line	:	8137 PENDLETON PIKE
Second Line	:
City	:	WASHINGTON
State	:	PA
Zip	:	15301-9697
Country	:	US
Telephone Number	:	724-225-3680
Fax Number	:

Provider Business Practice Location Address
First Line	:	8137 PENDLETON PIKE
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46226-4014
Country	:	US
Telephone Number	:	317-593-2500
Fax Number	:

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

Provider Enumeration Date	:	07/19/2023
Last Update Date	:	10/28/2024

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