Provider Demographics
NPI:1972732675
Name:PATEL, ROSHNI M (DMD)
Entity Type:Individual
Prefix:DR
First Name:ROSHNI
Middle Name:M
Last Name:PATEL
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1070 MORRIS AVE APT 1220
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-7161
Mailing Address - Country:US
Mailing Address - Phone:863-529-3682
Mailing Address - Fax:
Practice Address - Street 1:381 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083-9430
Practice Address - Country:US
Practice Address - Phone:908-686-2082
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-02
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0589441223P0221X
PADS0429721223P0221X
FLDN187421223P0221X
NJ22DI02815501223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry