MEDICARE: DR. SANDEEP VINUBHAI 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	23307	TX
2	122300000X	Dentist	DS039923	PA

General Provider Information

NPI Number	:	1508065806
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SANDEEP VINUBHAI PATEL DDS

Provider Business Mailing Address
First Line	:	304 N WATER ST
Second Line	:
City	:	LANCASTER
State	:	PA
Zip	:	17603-3374
Country	:	US
Telephone Number	:	717-735-6808
Fax Number	:

Provider Business Practice Location Address
First Line	:	101 S 9TH ST
Second Line	:
City	:	LEBANON
State	:	PA
Zip	:	17042-5108
Country	:	US
Telephone Number	:	717-450-7015
Fax Number	:

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

Provider Enumeration Date	:	07/16/2007
Last Update Date	:	03/04/2021

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