MEDICARE: DR. DHRUV B PATEL DMD

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	13822	NC
2	122300000X	Dentist	DN122398	GA
3	122300000X	Dentist	9972	SC

General Provider Information

NPI Number	:	1659044063
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DHRUV B PATEL DMD

Provider Business Mailing Address
First Line	:	1815 BECKLEY PL NW
Second Line	:
City	:	KENNESAW
State	:	GA
Zip	:	30152-4266
Country	:	US
Telephone Number	:	678-907-0904
Fax Number	:

Provider Business Practice Location Address
First Line	:	76 HIGHLAND PAVILION CT STE 145
Second Line	:
City	:	HIRAM
State	:	GA
Zip	:	30141-3170
Country	:	US
Telephone Number	:	678-907-0904
Fax Number	:

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

Provider Enumeration Date	:	07/30/2021
Last Update Date	:	03/05/2026

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