Individual provider Active NPI

Shreya Patel, DMD

  • Dentist
  • Waco, TX
National Provider Identifier
1023686789
Registry record updated Jun 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
37278 Issued in TX
Practice address
1428 Wooded Acres Dr Ste 126
Waco, TX 76710-4466
Phone
(254) 772-4000
NPI assigned
Jun 17, 2021
Last updated
Jun 17, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 37278 TX Primary

Addresses

Primary practice location

1428 Wooded Acres Dr Ste 126
Waco, TX 76710-4466

Mailing address

1009 Saint Peter Dr
Murphy, TX 75094-5110
Phone (972) 786-5415

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL https://waco.acedentaloftexas.com/

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
37278TXMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1623888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623888000000",
    "number": "1023686789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1009 SAINT PETER DR",
            "city": "MURPHY",
            "state": "TX",
            "postal_code": "750945110",
            "telephone_number": "972-786-5415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1428 WOODED ACRES DR STE 126",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767104466",
            "telephone_number": "254-772-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "SHREYA",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-17",
        "last_updated": "2021-06-17",
        "certification_date": "2021-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "37278",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://waco.acedentaloftexas.com/",
            "affiliation": "N",
            "address_1": "1428 Wooded Acres Dr Ste 126",
            "city": "Waco",
            "state": "TX",
            "country_code": "US",
            "postal_code": "767104466",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Waco, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2021; 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.