Provider Demographics
NPI:1760652861
Name:PATEL, RUSHI S (DDS)
Entity Type:Individual
Prefix:DR
First Name:RUSHI
Middle Name:S
Last Name:PATEL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2508 SW 35TH PL # U-121
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32608-3252
Mailing Address - Country:US
Mailing Address - Phone:816-547-8744
Mailing Address - Fax:352-637-2551
Practice Address - Street 1:1600 SW ARCHER RD
Practice Address - Street 2:ROOM D7-6
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32610-0416
Practice Address - Country:US
Practice Address - Phone:352-273-6750
Practice Address - Fax:352-392-7609
Is Sole Proprietor?:No
Enumeration Date:2008-03-04
Last Update Date:2010-04-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLDN177081223G0001X
FLDN-177081223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No1223G0001XDental ProvidersDentistGeneral Practice