Individual provider Active NPI

Ayushi Krunal Patel

  • General Practice Dentistry
  • Roanoke, VA
National Provider Identifier
1003659988
Registry record updated Jun 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
0401419028 Issued in VA
Practice address
1930 Electric Rd
Roanoke, VA 24018-1621
Phone
(540) 766-4338
NPI assigned
Jun 17, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 0401419028 VA Primary

Addresses

Primary practice location

1930 Electric Rd
Roanoke, VA 24018-1621

Mailing address

2540 Woods Meadow CT
Salem, VA 24153-1820
Phone (540) 892-4904

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0401419028VAMDGeneral Practice Dentistry

Networks

  • TN PPO C-SNP
  • KY PPO C-SNP

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1718582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718582400000",
    "number": "1003659988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2540 WOODS MEADOW CT",
            "city": "SALEM",
            "state": "VA",
            "postal_code": "241531820",
            "telephone_number": "540-892-4904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1930 ELECTRIC RD",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240181621",
            "telephone_number": "540-766-4338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "AYUSHI",
        "middle_name": "KRUNAL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-17",
        "last_updated": "2024-06-17",
        "certification_date": "2024-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401419028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.