Individual provider Active NPI

Niyati Patel

  • Dentist
  • South Pasadena, FL
National Provider Identifier
1043864168
Registry record updated Sep 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN24458 Issued in FL
Practice address
6882 Gulfport Blvd S
South Pasadena, FL 33707-2108
Phone
(727) 384-9655
NPI assigned
Jul 26, 2019
Last updated
Sep 1, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 1, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN24458 FL Primary

Addresses

Primary practice location

6882 Gulfport Blvd S
South Pasadena, FL 33707-2108

Mailing address

10622 Park Place Dr
Largo, FL 33778-3402
Phone (360) 622-5623

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20200805002589 FL Practitioner - Dentist 8022348028 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Opal Dental Care LLC Dentist Current Accepting new patients
Heart of Florida Health Center, Inc CurrentSince Jun 27, 2020 Accepting new patients
Coast Florida P.a. Dentist PastSince Jun 22, 2021 Accepting new patients
Coast Florida P.a. Dentist Past Accepting new patients

Locations

19204 E Pennsylvania Ave
Dunnellon, FL 34432
Phone (352) 465-2449

1025 SW 1st Ave
Ocala, FL 34471
Phone (352) 877-7140

6041 SW 54th St
Ste 100
Ocala, FL 34474
Phone (352) 854-0700

Networks

  • Freedom Health HMO Network

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1564099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788220800000",
    "number": "1043864168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10622 PARK PLACE DR",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337783402",
            "telephone_number": "360-622-5623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6882 GULFPORT BLVD S",
            "city": "SOUTH PASADENA",
            "state": "FL",
            "postal_code": "337072108",
            "telephone_number": "727-384-9655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "NIYATI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-26",
        "last_updated": "2026-09-01",
        "certification_date": "2026-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN24458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Pasadena, FL

Sources for this page

Verify at the official NPI Registry.