Provider Demographics
NPI:1497242341
Name:PATEL, RUPALI GIRISH (DMD, MS)
Entity type:Individual
Prefix:MRS
First Name:RUPALI
Middle Name:GIRISH
Last Name:PATEL
Suffix:
Gender:F
Credentials:DMD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1608 GREEN ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19130-3910
Mailing Address - Country:US
Mailing Address - Phone:908-400-4789
Mailing Address - Fax:
Practice Address - Street 1:7155 OGONTZ AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19138-2015
Practice Address - Country:US
Practice Address - Phone:215-276-4532
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-17
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS042145122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist