Provider Demographics
NPI:1871294645
Name:PATEL, RISHI AMRISH (DMD)
Entity type:Individual
Prefix:DR
First Name:RISHI
Middle Name:AMRISH
Last Name:PATEL
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:327 N OLD WOODWARD AVE UNIT 401
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:MI
Mailing Address - Zip Code:48009-5338
Mailing Address - Country:US
Mailing Address - Phone:248-258-9945
Mailing Address - Fax:
Practice Address - Street 1:4597 W WALTON BLVD
Practice Address - Street 2:
Practice Address - City:WATERFORD TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48329-4078
Practice Address - Country:US
Practice Address - Phone:248-673-8898
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-16
Last Update Date:2025-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MI29016020541223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program