MEDICARE: DR. RISHI AMRISH 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	390200000X	Student in an Organized Health Care Education/Training Program
2	1223G0001X	General Practice Dentistry	2901602054	MI

General Provider Information

NPI Number	:	1871294645
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RISHI AMRISH PATEL DMD

Provider Business Mailing Address
First Line	:	327 N OLD WOODWARD AVE UNIT 401
Second Line	:
City	:	BIRMINGHAM
State	:	MI
Zip	:	48009-5338
Country	:	US
Telephone Number	:	248-258-9945
Fax Number	:

Provider Business Practice Location Address
First Line	:	4597 W WALTON BLVD
Second Line	:
City	:	WATERFORD TOWNSHIP
State	:	MI
Zip	:	48329-4078
Country	:	US
Telephone Number	:	248-673-8898
Fax Number	:

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

Provider Enumeration Date	:	03/16/2023
Last Update Date	:	07/29/2025

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