Roshan Vijay Patel, D.M.D

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

36187 Issued in TX

Practice address

5700 Edwards Ranch Rd Ste 100
Fort Worth, TX 76109-4128

Phone

(817) 292-2004

Fax

(817) 292-7083

NPI assigned

Jul 1, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Preece Church and Associates, Pediatric Dentistry

  • Pediatric Dentistry
  • Fort Worth, TX
  • NPI 1043754740
  NPD (past)
• Kevin W Snyder DDS, PA

  dba Harbour Dental Care

  • Dental Clinic/Center
  • Jacksonville, FL
  • NPI 1881096006
  NPD (past)

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

{
    "created_epoch": "1404172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623369600000",
    "number": "1114333903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5700 EDWARDS RANCH RD STE 100",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761094128",
            "telephone_number": "817-292-2004",
            "fax_number": "817-292-7083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5700 EDWARDS RANCH RD STE 100",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761094128",
            "telephone_number": "817-292-2004",
            "fax_number": "817-292-7083"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13245 Atlantic Blvd Ste 6",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322257118",
            "country_code": "US",
            "telephone_number": "904-220-7800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "Unc School Of Dentistry",
            "address_2": "401 Brauer Hall",
            "address_purpose": "LOCATION",
            "city": "Chapel Hill",
            "state": "NC",
            "postal_code": "275990001",
            "country_code": "US",
            "telephone_number": "919-537-3591",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3333 Burnet Ave",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "45229",
            "country_code": "US",
            "telephone_number": "513-636-4641",
            "fax_number": "513-636-8283",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATEL",
        "first_name": "ROSHAN",
        "middle_name": "VIJAY",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-01",
        "last_updated": "2021-06-11",
        "certification_date": "2021-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NC",
            "license": "0977",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "20642",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30.025952",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TX",
            "license": "36187",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "020110100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Priya Patel, MD
• Priyank Patel
• Rahul Patel
• Rahul K Patel, MD
• Ritu Patel
• Rutu Patel, PHARMD
• Sachin P Patel, PT, MPT, DPT
• Sahil Patel, DDS
• Shaan Barindra Patel, MD
• Shailesh Patel, PHARMACIST

• Pediatric Dentistry in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Pediatric Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 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.