MEDICARE: AJIT PATEL DDS INC

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	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1861206831
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AJIT PATEL DDS INC

Provider Business Mailing Address
First Line	:	1383 N CITRUS AVE
Second Line	:
City	:	COVINA
State	:	CA
Zip	:	91722-1748
Country	:	US
Telephone Number	:	626-727-2118
Fax Number	:

Provider Business Practice Location Address
First Line	:	1383 N CITRUS AVE
Second Line	:
City	:	COVINA
State	:	CA
Zip	:	91722-1748
Country	:	US
Telephone Number	:	626-727-2118
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	AJITKUMAR PATEL
Credential	:
Telephone Number	:	909-913-4916

Provider Enumeration Date	:	02/01/2025
Last Update Date	:	02/01/2025

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