Individual provider Active NPI

Manisha Vrajesh Patel, D.D.S.

  • Dentist
  • Troy, MI
National Provider Identifier
1104082916
Registry record updated Jul 31, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2901015961 Issued in MI
Practice address
6053 Rochester Rd
Troy, MI 48085-1303
Phone
(248) 879-5858
NPI assigned
Jul 31, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2901015961 MI Primary

Addresses

Primary practice location

6053 Rochester Rd
Troy, MI 48085-1303

Mailing address

6053 Rochester Rd
Troy, MI 48085-1303
Phone (248) 879-5858

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
2901015961MIMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1217462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217462400000",
    "number": "1104082916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6053 ROCHESTER RD",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480851303",
            "telephone_number": "248-879-5858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6053 ROCHESTER RD",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480851303",
            "telephone_number": "248-879-5858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "MANISHA",
        "middle_name": "VRAJESH",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-31",
        "last_updated": "2008-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901015961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2008; 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.