Raj Patel, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

DN26109 Issued in FL

Practice address

66 N Holiday Rd
Miramar Beach, FL 32550

Phone

(850) 213-2626

NPI assigned

Jun 24, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Ynr Dental Services LLC

  • General Practice Dentistry
  • Miramar Beach, FL
  • NPI 1699478354
  NPD Authorized official
• Beachview Dental PLLC

  dba Sunrise Dental of Orange Park

  • Dental Clinic/Center
  • Orange Park, FL
  • NPI 1528618071
  NPD
• TDN Dentistry, PLLC

  dba Sunrise Emergency & Family Dental Care

  • General Practice Dentistry
  • Orange Park, FL
  • NPI 1538950845
  NPD

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

{
    "created_epoch": "1624492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679443200000",
    "number": "1124697032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 N HOLIDAY RD",
            "city": "MIRAMAR BEACH",
            "state": "FL",
            "postal_code": "325506936",
            "telephone_number": "850-213-2626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "66 N HOLIDAY RD",
            "city": "MIRAMAR BEACH",
            "state": "FL",
            "postal_code": "32550",
            "telephone_number": "850-213-2626"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1700 Wells Rd Ste 19",
            "address_purpose": "LOCATION",
            "city": "Orange Park",
            "state": "FL",
            "postal_code": "320732374",
            "country_code": "US",
            "telephone_number": "904-586-1234",
            "fax_number": "904-467-2400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATEL",
        "first_name": "RAJ",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-06-24",
        "last_updated": "2023-03-22",
        "certification_date": "2023-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN26109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Derek Viktor-Carr Odgers, RBT
• On Demand Transportation, LLC
• Ekaterina Page
• Nicholas George Papajohn, M.D.
• Eric D Parod, PHARMD
• Yassar Patel, DMD
• Bobbie Sue Pearson, NP-C
• Pediatrix Medical Group of Florida Inc
• Mina Perez, RBT
• Katlyn Perkins, DO

• Dentist in Miramar Beach, FL
• Providers in Miramar Beach, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2023; 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.