MEDICARE: ANIRUDH 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	1223G0001X	General Practice Dentistry	DS041312	PA

General Provider Information

NPI Number	:	1295263259
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANIRUDH PATEL DDS

Provider Business Mailing Address
First Line	:	598 STOCKDALE DR
Second Line	:
City	:	LANCASTER
State	:	PA
Zip	:	17601-5181
Country	:	US
Telephone Number	:	630-589-9567
Fax Number	:

Provider Business Practice Location Address
First Line	:	7052 FRANKFORD AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19135-1617
Country	:	US
Telephone Number	:	215-624-1935
Fax Number	:	215-624-5651

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

Provider Enumeration Date	:	06/02/2017
Last Update Date	:	01/31/2022

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Directions to “ ANIRUDH PATEL DDS” Practice Location

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