MEDICARE: DR. MOHIT PATEL

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	32294	TX

General Provider Information

NPI Number	:	1992250229
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MOHIT PATEL

Provider Business Mailing Address
First Line	:	4767 VISTA WOODS BLVD
Second Line	:	STE 110
City	:	DALLAS
State	:	TX
Zip	:	75232-1358
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4767 VISTA WOODS BLVD
Second Line	:	STE 110
City	:	DALLAS
State	:	TX
Zip	:	75232-1358
Country	:	US
Telephone Number	:	972-408-7099
Fax Number	:

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

Provider Enumeration Date	:	08/16/2016
Last Update Date	:	08/16/2016

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Directions to “ DR. MOHIT PATEL ” Practice Location

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