MEDICARE: VIKASKUMAR 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	15616	MD

General Provider Information

NPI Number	:	1528475274
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VIKASKUMAR PATEL

Provider Business Mailing Address
First Line	:	18121 GEORGIA AVE STE 110
Second Line	:
City	:	OLNEY
State	:	MD
Zip	:	20832-1437
Country	:	US
Telephone Number	:	240-390-0290
Fax Number	:

Provider Business Practice Location Address
First Line	:	18121 GEORGIA AVE STE 110
Second Line	:
City	:	OLNEY
State	:	MD
Zip	:	20832-1437
Country	:	US
Telephone Number	:	240-390-0290
Fax Number	:

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

Provider Enumeration Date	:	07/15/2014
Last Update Date	:	06/14/2023

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Directions to “ VIKASKUMAR PATEL ” Practice Location

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