DR. ROSHAN VIJAY PATEL D.M.D NPI 1114333903

NPI Information

NPI: 1114333903
Provider Name: DR. ROSHAN VIJAY PATEL, D.M.D
Classification: Dentist - 1223P0221X
Entity Type: Individual

Specialization: Pediatric Dentistry

Address:
5700 EDWARDS RANCH RD STE 100
FORT WORTH, TX
ZIP 76109
Phone: (817) 292-2004
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DR. Roshan Vijay Patel, D.M.D is a pediatric dentistry dentist in Fort Worth, TX. The provider is an age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. DR. Roshan Vijay Patel, D.M.D NPI is 1114333903. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

5700 EDWARDS RANCH RD STE 100
FORT WORTH, TX
ZIP 76109-128
Phone: (817) 292-2004
Fax: (817) 292-7083

The enumeration date for this NPI number is 7/1/2014 and was last updated on 6/11/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	122300000X	Dentist		20642	FLORIDA	No
2	122300000X	Dentist		0977	NORTH CAROLINA	No
3	1223G0001X	Dentist	General Practice	30.025952	OHIO	No
4	1223P0221X	Dentist	Pediatric Dentistry	36187	TEXAS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	020110100	MEDICAID	FLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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