Individual provider Active NPI

Puja Satish Patel, DMD

  • General Practice Dentistry
  • Brandon, FL
National Provider Identifier
1114485307
Registry record updated Sep 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN24809 Issued in FL
Practice address
787 W Lumsden Road
Family Implant and Cosmetic Dentistry
Brandon, FL 33511
Phone
(813) 684-7888
Fax
(813) 684-4568
NPI assigned
Mar 6, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN24809 FL Primary

Addresses

Primary practice location

787 W Lumsden Road
Family Implant and Cosmetic Dentistry
Brandon, FL 33511

Mailing address

787 W Lumsden Road
Family Implant and Cosmetic Dentistry
Brandon, FL 33511
Phone (813) 684-7888

Other practice location 1

2717 Lake Valley Pl
Wesley Chapel, FL 33544-8745
Phone (813) 907-2767

Other practice location 2

15277 Amberly Dr
Tampa, FL 33647-2155
Phone (813) 971-1688

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
DN24809FLMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
RR Dentistry Trinity, PLLC General Practice Past Accepting new patients
Florida Dental Professionals, P.a. General Practice PastSince May 29, 2022 Accepting new patients
Tampa Palms Dentistry, PLLC General Practice Past Accepting new patients
RRR Dentistry, PLLC General Practice Past Accepting new patients
Louis P Cerillo, DDS, PA Past Accepting new patients

Organizations & group practices 5

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": "1551830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664496000000",
    "number": "1114485307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "787 W LUMSDEN ROAD",
            "address_2": "FAMILY IMPLANT AND COSMETIC DENTISTRY",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "33511",
            "telephone_number": "813-684-7888",
            "fax_number": "813-684-4568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "787 W LUMSDEN ROAD",
            "address_2": "FAMILY IMPLANT AND COSMETIC DENTISTRY",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "33511",
            "telephone_number": "813-684-7888",
            "fax_number": "813-684-4568"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2717 Lake Valley Pl",
            "address_purpose": "LOCATION",
            "city": "Wesley Chapel",
            "state": "FL",
            "postal_code": "335448745",
            "country_code": "US",
            "telephone_number": "813-907-2767",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15277 Amberly Dr",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336472155",
            "country_code": "US",
            "telephone_number": "813-971-1688",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATEL",
        "first_name": "PUJA",
        "middle_name": "SATISH",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-06",
        "last_updated": "2022-09-30",
        "certification_date": "2022-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN24809",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2022; 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.