MEDICARE: PATEL AND HUSS DENTAL CORPORATION

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

General Provider Information

NPI Number	:	1851632657
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PATEL AND HUSS DENTAL CORPORATION

Provider Business Mailing Address
First Line	:	PO BOX 920050
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75392-0050
Country	:	US
Telephone Number	:	714-368-2084
Fax Number	:	714-368-2092

Provider Business Practice Location Address
First Line	:	5784 LINDERO CANYON RD STE B
Second Line	:
City	:	WESTLAKE VILLAGE
State	:	CA
Zip	:	91362-4088
Country	:	US
Telephone Number	:	818-706-0131
Fax Number	:	818-706-0151

Authorized Official
Title or Position	:	OWNER DOCTOR
Name	:	DR. CHANDNI PATEL
Credential	:	DDS
Telephone Number	:	818-706-0131

Provider Enumeration Date	:	03/05/2013
Last Update Date	:	03/08/2022

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