Individual provider Active NPI

Hemal Aditya Pandya Mehta, DDS

  • General Practice Dentistry
  • Modesto, CA
National Provider Identifier
1144050311
Registry record updated Oct 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
110429 Issued in CA
Practice address
2119 E Hatch Rd Ste Band
Modesto, CA 95351-4814
Phone
(209) 758-5437
NPI assigned
Aug 3, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2024

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 110429 CA Primary

Addresses

Primary practice location

2119 E Hatch Rd Ste Band
Modesto, CA 95351-4814

Mailing address

3674 Branding Iron PL
Dublin, CA 94568-7297
Phone (626) 384-7731

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20251103003678 CA Order and Referring Only - DentistPractitioner - Dentist 1052801693

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
110429CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1722643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729209600000",
    "number": "1144050311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3674 BRANDING IRON PL",
            "city": "DUBLIN",
            "state": "CA",
            "postal_code": "945687297",
            "telephone_number": "626-384-7731",
            "fax_number": "626-384-7731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2119 E HATCH RD STE BAND",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953514814",
            "telephone_number": "209-758-5437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANDYA MEHTA",
        "first_name": "HEMAL",
        "middle_name": "ADITYA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-03",
        "last_updated": "2024-10-18",
        "certification_date": "2024-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "110429",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

Verify at the official NPI Registry.