MEDICARE: DR. MANALI SHAH 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	104231	CA

General Provider Information

NPI Number	:	1659926939
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MANALI SHAH PATEL DDS

Provider Business Mailing Address
First Line	:	4911 WARNER AVE STE 202
Second Line	:
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92649-4473
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4911 WARNER AVE STE 202
Second Line	:
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92649-4473
Country	:	US
Telephone Number	:	714-846-4414
Fax Number	:	714-846-7655

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

Provider Enumeration Date	:	08/05/2019
Last Update Date	:	05/11/2026

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