Provider Demographics
NPI:1750951885
Name:PATEL, RUCHI MUKESH (DMD)
Entity type:Individual
Prefix:
First Name:RUCHI
Middle Name:MUKESH
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 1:3426 ENCLAVE BAY DR
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37415-5669
Mailing Address - Country:US
Mailing Address - Phone:407-201-1228
Mailing Address - Fax:
Practice Address - Street 1:8021 E BRAINERD RD
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-0004
Practice Address - Country:US
Practice Address - Phone:423-800-5991
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-30
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL261811223G0001X
TN120281223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice