Individual provider Active NPI

Jyoti Aryal

  • Dentist
  • Raleigh, NC
National Provider Identifier
1063195964
Registry record updated Apr 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
13627 Issued in NC
Practice address
1011 Rock Quarry Rd
Raleigh, NC 27610-3825
Phone
(919) 833-3111
NPI assigned
Aug 8, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 109066 CA
Dentist 122300000X 13627 NC Primary

Addresses

Primary practice location

1011 Rock Quarry Rd
Raleigh, NC 27610-3825

Mailing address

21313 E Smoky Hill Rd
Centennial, CO 80015-6754
Phone (720) 375-5336

Other practice location 1

4060 Fairmount Ave
San Diego, CA 92105-1608
Phone (619) 280-4213

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20240513001040 NC Practitioner - Dentist 1355782038 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
109066CAMDMarriage & Family Therapist
13627NCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Advance Community Health, Inc CurrentSince Apr 22, 2024 Accepting new patients
Advance Community Health, Inc CurrentSince Apr 22, 2024 Accepting new patients

Locations

212 S Salem St
Apex, NC 27502
Phone (919) 362-5201

1011 Rock Quarry Rd
Raleigh, NC 27610

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1691452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712534400000",
    "number": "1063195964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21313 E SMOKY HILL RD",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "800156754",
            "telephone_number": "720-375-5336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 ROCK QUARRY RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276103825",
            "telephone_number": "919-833-3111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4060 Fairmount Ave",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921051608",
            "country_code": "US",
            "telephone_number": "619-280-4213",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ARYAL",
        "first_name": "JYOTI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-08",
        "last_updated": "2024-04-08",
        "certification_date": "2024-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "109066",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NC",
            "license": "13627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.