MEDICARE: DR. KAJAL 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	43838	CA

General Provider Information

NPI Number	:	1538278387
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KAJAL PATEL DDS

Provider Business Mailing Address
First Line	:	1531 SILVER POND LN
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95138-2759
Country	:	US
Telephone Number	:	408-313-6275
Fax Number	:

Provider Business Practice Location Address
First Line	:	1531 SILVER POND LN
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95138-2759
Country	:	US
Telephone Number	:	408-313-6275
Fax Number	:

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

Provider Enumeration Date	:	08/29/2006
Last Update Date	:	06/29/2009

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