MEDICARE: DR. CHHAGANBHAI 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	033316	NY

General Provider Information

NPI Number	:	1720077621
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHHAGANBHAI PATEL DDS

Provider Business Mailing Address
First Line	:	45 LUDLOW ST
Second Line	:	SUITE 606
City	:	YONKERS
State	:	NY
Zip	:	10705-1947
Country	:	US
Telephone Number	:	914-423-2493
Fax Number	:	914-423-0263

Provider Business Practice Location Address
First Line	:	45 LUDLOW ST
Second Line	:	SUITE 606
City	:	YONKERS
State	:	NY
Zip	:	10705-1947
Country	:	US
Telephone Number	:	914-423-2493
Fax Number	:	914-423-0263

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

Provider Enumeration Date	:	10/14/2005
Last Update Date	:	07/08/2007

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