Individual provider Active NPI

Minal J Patel, DMD

  • General Practice Dentistry
  • Redwood City, CA
National Provider Identifier
1023326345
Registry record updated Mar 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
60628 Issued in CA
Practice address
3221 Jefferson Ave Ste 2B
Redwood City, CA 94062-3068
Phone
(650) 366-0998
NPI assigned
Sep 21, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 60628 CA
General Practice Dentistry 1223G0001X 60628 CA Primary

Addresses

Primary practice location

3221 Jefferson Ave Ste 2B
Redwood City, CA 94062-3068

Mailing address

3221 Jefferson Ave Ste 2B
Redwood City, CA 94062-3068

Other practice location 1

3221 Jefferson Ave Ste 2B
Redwood City, CA 94062-3068
Phone (650) 366-0998

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160623002214 CA Order and Referring Only - DentistPractitioner - Dentist 2961793856

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1285027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553472000000",
    "number": "1023326345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3221 JEFFERSON AVE STE 2B",
            "city": "REDWOOD CITY",
            "state": "CA",
            "postal_code": "940623068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3221 JEFFERSON AVE STE 2B",
            "city": "REDWOOD CITY",
            "state": "CA",
            "postal_code": "940623068",
            "telephone_number": "650-366-0998"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3221 Jefferson Ave Ste 2B",
            "address_purpose": "LOCATION",
            "city": "Redwood City",
            "state": "CA",
            "postal_code": "940623068",
            "country_code": "US",
            "telephone_number": "650-366-0998",
            "fax_number": "650-366-0367",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATEL",
        "first_name": "MINAL",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-21",
        "last_updated": "2019-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "60628",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "60628",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redwood City, CA

Sources for this page

Verify at the official NPI Registry.