Provider Demographics
NPI:1811974702
Name:PATEL, UGTI (DMD)
Entity type:Individual
Prefix:
First Name:UGTI
Middle Name:
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 1:100 SHENANGO AVE
Mailing Address - Street 2:
Mailing Address - City:SHARON
Mailing Address - State:PA
Mailing Address - Zip Code:16146-1503
Mailing Address - Country:US
Mailing Address - Phone:724-981-1721
Mailing Address - Fax:724-981-7025
Practice Address - Street 1:350 SHARON NEW CASTLE RD
Practice Address - Street 2:
Practice Address - City:FARRELL
Practice Address - State:PA
Practice Address - Zip Code:16121-1576
Practice Address - Country:US
Practice Address - Phone:724-981-1721
Practice Address - Fax:724-981-7025
Is Sole Proprietor?:No
Enumeration Date:2005-12-30
Last Update Date:2019-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS027951L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0012711420010Medicaid
PA0012711420012Medicaid
OH2617636Medicaid
PA0012711420006Medicaid
PA0012711420008Medicaid
OH2395411Medicaid
PA0012711420013Medicaid
PA0012711420007Medicaid
PA0012711420009Medicaid