Individual provider Active NPI

Ghata D Patel

  • Dentist
  • Laurel, MD
National Provider Identifier
1124479647
Registry record updated Jun 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
15986 Issued in MD
Practice address
9072 Manorwood Rd
Laurel, MD 20723
Phone
(240) 893-0961
NPI assigned
Jun 27, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 15986 MD Primary

Addresses

Primary practice location

9072 Manorwood Rd
Laurel, MD 20723

Mailing address

9072 Manorwood Rd
Laurel, MD 20723
Phone (240) 893-0961

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20180425001480 MD Order and Referring Only - DentistPractitioner - Dentist 0345504445

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Interoperability endpoints

  • Direct secure messaging: gpatel694194@direct.umm.edu

NPI Registry JSON

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

{
    "created_epoch": "1466985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466985600000",
    "number": "1124479647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9072 MANORWOOD RD",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "20723",
            "telephone_number": "240-893-0961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9072 MANORWOOD RD",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "20723",
            "telephone_number": "240-893-0961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "GHATA",
        "middle_name": "D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-27",
        "last_updated": "2016-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MD",
            "license": "15986",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laurel, MD

Sources for this page

Verify at the official NPI Registry.