Provider Demographics
NPI:1285041830
Name:PATEL, RUSHANG S (DDS)
Entity Type:Individual
Prefix:DR
First Name:RUSHANG
Middle Name:S
Last Name:PATEL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2055 SACRAMENTO ST APT 202
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94109-3320
Mailing Address - Country:US
Mailing Address - Phone:408-768-6665
Mailing Address - Fax:
Practice Address - Street 1:2055 SACRAMENTO ST APT 202
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94109-3320
Practice Address - Country:US
Practice Address - Phone:408-768-6665
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-15
Last Update Date:2021-04-20
Deactivation Date:2021-02-12
Deactivation Code:
Reactivation Date:2021-04-20
Provider Licenses
StateLicense IDTaxonomies
CA63650122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist