MEDICARE: DR. SHREENA JITENDRA 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	2901021119	MI
2	122300000X	Dentist	30.028158	OH

General Provider Information

NPI Number	:	1477983864
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHREENA JITENDRA PATEL DDS

Provider Business Mailing Address
First Line	:	3420 ATRIUM BLVD STE 100
Second Line	:
City	:	MIDDLETOWN
State	:	OH
Zip	:	45005-5186
Country	:	US
Telephone Number	:	855-912-7677
Fax Number	:	513-424-2147

Provider Business Practice Location Address
First Line	:	3420 ATRIUM BLVD STE 100
Second Line	:
City	:	MIDDLETOWN
State	:	OH
Zip	:	45005-5186
Country	:	US
Telephone Number	:	855-912-7677
Fax Number	:	513-424-2147

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

Provider Enumeration Date	:	11/20/2013
Last Update Date	:	09/26/2025

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