Active NPI
Suchi Navinchandra Patel, DMD
- Dentist
- Bloomington, IL
National Provider Identifier
1124834544
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 6001624
- Practice address
- 2701 Handel Dr
Bloomington, IL 61704 - Phone
- (815) 419-7025
- NPI assigned
- Dec 10, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 019.035424 | IL | |
| Dentist | 122300000X | 6001624 | WI | Primary |
Addresses
Primary practice location
2701 Handel Dr
Bloomington, IL 61704
Mailing address
2701 Handel Dr
Bloomington, IL 61704
Phone (815) 419-7025
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
| License | State | Type | Specialty |
|---|---|---|---|
| 019.035424 | IL | MD | Dentist |
| 6001624 | WI | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1733788800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1733788800000",
"number": "1124834544",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2701 HANDEL DR",
"city": "BLOOMINGTON",
"state": "IL",
"postal_code": "61704",
"telephone_number": "815-419-7025"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2701 HANDEL DR",
"city": "BLOOMINGTON",
"state": "IL",
"postal_code": "61704",
"telephone_number": "815-419-7025"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATEL",
"first_name": "SUCHI",
"middle_name": "NAVINCHANDRA",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-12-10",
"last_updated": "2024-12-10",
"certification_date": "2024-12-10",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IL",
"license": "019.035424",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WI",
"license": "6001624",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bloomington, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.