Individual provider Active NPI

Mukesh Uttam Patel, DDS

  • Dentist
  • Garland, TX
National Provider Identifier
1053421339
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
18700 Issued in TX
Practice address
2334 W Buckingham Rd
Suite #340
Garland, TX 75042-4934
Phone
(972) 276-2451
Fax
(972) 276-2451
NPI assigned
Aug 30, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 18700 TX Primary

Addresses

Primary practice location

2334 W Buckingham Rd
Suite #340
Garland, TX 75042-4934

Mailing address

2334 W Buckingham Rd
Suite #340
Garland, TX 75042-4934
Phone (972) 276-2451

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20160324000784 TX Order and Referring Only - DentistPractitioner - Dentist 5496069064

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": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053421339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2334 W BUCKINGHAM RD",
            "address_2": "SUITE #340",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750424934",
            "telephone_number": "972-276-2451",
            "fax_number": "972-276-2451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2334 W BUCKINGHAM RD",
            "address_2": "SUITE #340",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750424934",
            "telephone_number": "972-276-2451",
            "fax_number": "972-276-2451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "MUKESH",
        "middle_name": "UTTAM",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "18700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garland, TX

Sources for this page

Verify at the official NPI Registry.